Cigarette smoking remains common, particularly in rural areas, despite ample evidence that smoking causes cancer and respiratory disease. Successful smoking cessation yields the majority of its health benefits (e.g., avoidance of lung cancer) after years of sustained behavioral change; however, people who smoke cigarettes tend to show elevated rates of delay discounting (i.e., devaluation of delayed outcomes) and a bias for immediate gratification. The overall goal of this project is to develop different versions of an episodic future thinking intervention (i.e., visualization of the future) and test their feasibility and efficacy for smoking cessation in rural and urban populations.
smoked cigarettes daily for the last 30 days;
salivary cotinine > 30 ng/mL, consistent with tobacco use;
plan to quit smoking in the next 30 days
prior diagnosis with a smoking-related illness (e.g., respiratory disease);
past 30-day use any smoking cessation treatment;
anxiety or mood disorders; and
medical contraindications for use of nicotine replacement therapy (e.g. pregnancy).
Factorial
Episodic Future Thinking (EFT)
BehavioralParticipants will engage in EFT for 8 weeks, three times a day. Participants will receive three daily text messages. Each prompt will link to a custom web interface that guides participants to read and vividly imagine one of their cues, chosen randomly. Visit times and durations will be recorded.
Episodic Recent Thinking (ERT)
BehavioralParticipants will engage in ERT for 8 weeks, three times a day. Participants will receive three daily text messages. Each prompt will link to a custom web interface that guides participants to read and vividly imagine one of their cues, chosen randomly. Visit times and durations will be recorded.
Domain-specific episodic thinking
BehavioralContent of the episodic thinking intervention will experiencing the symptoms of lung cancer during a broad range of personally meaningful, otherwise positive, events (e.g., social events, celebrations, spending times with friends and family).
Generalized episodic thinking
BehavioralContent of the episodic thinking intervention will include a broad range of personally meaningful, positive, events (e.g., social events, celebrations, spending times with friends and family).
Cigarettes smoked per day
A timeline followback questionnaire will be used to assess the number of cigarettes smoked per day. Lower values reflect better outcomes.
Other tobacco/nicotine product use per day
A timeline followback questionnaire will be used to assess the number of times participants use other tobacco/nicotine products per day (excluding cigarettes and nicotine patch). Lower values reflect better outcomes.
7-day point prevalence cigarette abstinence
A timeline followback questionnaire will be used to assess cigarette abstinence status (binary) over the final seven days of the intervention.
Nicotine patch adherence (feasibility outcome)
A timeline followback questionnaire will be used to assess frequency of use of the study-provided nicotine patches. Higher values reflect better adherence to nicotine replacement therapy.
Depressive symptoms (feasibility outcome)
Depression symptoms over the last 2 weeks will be assessed using the Patient Health Questionnaire-8 (PHQ-8). Total scores on this scale range from 0 (no depressive symptoms) to 24 (severe depressive symptoms).
Anxiety symptoms (feasibility outcome)
Anxiety symptoms over the last 2 weeks will be assessed using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Total scores on this scale range from 0 (no anxiety symptoms) to 21 (severe anxiety symptoms).
Episodic thinking adherence (feasibility outcome)
Adherence to the episodic thinking interventions will be measured as the percentage of daily cue prompts that participants access.
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Virginia Polytechnic Institute and State University
Lead sponsor
National Cancer Institute (NCI)
Collaborator
Roswell Park Comprehensive Cancer Center
Collaborator
