Letting the urge pass: Can an app focused on acceptance help quit smoking?

*Disclaimer: Please note that parts of this English sci-fly were automatically translated.*

During moments of stress or high emotion, do you notice feeling more tempted to give in to unhealthy habits, such as a cigarette? Emotional tension can trigger a craving for smoking.

This may explain why quitting smoking is especially difficult for people with mental illness, as they are on average more likely to experience (difficulty dealing with) negative emotions. Could an app focused on acceptance of cravings rather than avoidance offer a solution? A recent study examines whether the iCanQuit app, based on Acceptance and Commitment Therapy (ACT), is more effective than a regular stop app.

Background

• iCanQuit app helped more people with mental illness quit smoking than a regular quit app.
• The effectiveness of the iCanQuit app was related to increased acceptance of emotions that triggered smoking and active app use.
• Users of the iCanQuit app were more satisfied and found the app more useful.
• Interventions should focus on acceptance of feelings that trigger smoking propensity rather than avoidance of these feelings.
• More research is needed on integration of the app with the regular treatment of mental disorders, for example in comorbidity of disorders.

Research methods

WHAT?
This study compares the effectiveness of an app based on ACT (iCanQuit) with an app based on the US Clinical Practice Guidelines (QuitGuide) in adults with mental illness. Whereas the iCanQuit app emphasizes acceptance of internal triggers and using personal life values to motivate quitting, the QuitGuide app provides more techniques and information about triggers to smoking, barriers to quitting and negative health consequences of smoking.

WHO?

1504 smoking adults from the United States with a diagnosis of a mental disorder. The disorder was based on self-report (bipolar disorder and schizophrenia) or on a screening questionnaire (depression, generalized anxiety disorder, panic disorder, social anxiety disorder, panic disorder and PTSD).

HOW?
The study used data from a 12-month randomized trial comparing the iCanQuit app to QuitGuide. Data were collected between 2017 and 2019 through online questionnaires. Participants reported (among others) abstinence (not smoking for at least 30 days), app use and satisfaction, and acceptance of sensations, feelings and thoughts that trigger smoking.

RESULTS

• Among people with mental illness, users of iCanQuit were significantly more likely to quit smoking than those of QuitGuide (24.6% vs. 20.4%).
• Users of iCanQuit used the app more intensively: they logged in more often and used the app longer per login.
• Also, iCanQuit users were more satisfied with the app: they found the app more useful and better suited to their own situation.
• The effectiveness of the app was mediated by 1) increased acceptance of internal experiences that trigger smoking and 2) app engagement.

DETAILS

Santiago-Torres, M., Mull, K. E., Sullivan, B. M., Prochaska, J. J., Zvolensky, M. J., & Bricker, J. B. (2024). Can an Acceptance and Commitment Therapy‐Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking?. Depression and Anxiety, 2024(1), 1055801. https://doi.org/10.1155/2024/1055801

This sci-fly was written by Dagmar Nollet (research master’s student in Behavioural Science, Radboud University) for RAD-blog, the blog on smoking, alcohol, drugs and diet.