TOPLINE:
Adults from low-income populations who used a smartphone application that delivered tailored, real-time content quit smoking at much higher rates after about 6 months than those who received standard digital support; they also used the application more frequently and found it more helpful.
METHODOLOGY:
- Researchers conducted a randomized trial to examine whether a smartphone-based intervention that gave personalized, real-time support could help adults with low incomes quit smoking.
- They included 454 adults (mean age, 52 years; 73.3% women) with household incomes at or below 200% of the federal poverty line, who exhaled a carbon monoxide level of ≥ 7 ppm and were ready to quit smoking within 1 week.
- Participants were randomly assigned to either use Smart-T or the National Cancer Institute (NCI) QuitGuide intervention; both groups received nicotine replacement therapy.
- The Smart-T application sent tailored, real-time messages providing motivation, general advice on smoking cessation, coping strategies, and reinforcement of abstinence; it also included a one-tap “call counselor” feature. The QuitGuide application delivered standard, guideline-based advice on smoking cessation.
- The primary outcome was 7-day abstinence at 26 weeks after the date of quitting, defined as self-reported no-smoking in the past 7 days and a carbon monoxide reading of ≤ 6 ppm.
TAKEAWAY:
- At 26 weeks, Smart-T users were 1.81 times more likely to abstain from smoking in the past 7 days than QuitGuide users (95% CI, 1.03-3.18); however, 30-day quit rates were not significantly different.
- At least one on-demand quit tip was accessed by 92.9% of Smart-T users and 81.3% used the call counselor feature.
- Smart-T users requested nicotine replacement therapy more frequently than QuitGuide users (mean number of requests, 2.51 vs 1.71; P < .001).
- Compared with QuitGuide users, Smart-T users felt more aware of their thoughts and behaviors, found the intervention useful, and were more likely to recommend the application to others (P < .05 for all).
IN PRACTICE:
“These findings suggest that the Smart-T intervention shows promise as a low-cost, accessible tool for smoking cessation among adults with low SES [socioeconomic status] and may help overcome barriers limiting traditional cessation programs,” the authors of the study wrote. “Given the ubiquity of smartphones, interventions like Smart-T could play a key role in reducing smoking-related health disparities and improving public health,” they added.
SOURCE:
This study was led by Emily T. Hébert, DrPH, of the University of Oklahoma Health Sciences in Oklahoma City. It was published online on August 14, 2025, in JAMA Network Open.
LIMITATIONS:
Participants were required to set a quit date exactly 7 days after enrollment, limiting generalizability to those less prepared to quit smoking. Smart-T was only available on Android devices during the trial. Recruitment through digital platforms and a cessation program may have limited participation from individuals with lower digital literacy or those not actively seeking to quit.
DISCLOSURES:
This study received support from the NCI and used resources partially funded by NCI. Additional funding came from the Oklahoma Tobacco Settlement Endowment Trust and the Oklahoma Shared Clinical and Translational Resources through an Institutional Development Award from the National Institute of General Medical Sciences. One author reported receiving royalties from Insight Mobile Health Platform (used for data management in this study) and personal fees from Qnovia. Two other authors reported owning patents with royalties paid from the Insight Platform, while another author reported having a patent application for a device to verify recent smoking status.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.