scholarly journals Remote Patient Monitoring and Incentives to Support Smoking Cessation Among Pregnant and Postpartum Medicaid Members: Three Randomized Controlled Pilot Studies

10.2196/27801 ◽  
2021 ◽  
Vol 5 (9) ◽  
pp. e27801
Author(s):  
Caroline M Joyce ◽  
Kathryn Saulsgiver ◽  
Salini Mohanty ◽  
Chethan Bachireddy ◽  
Carin Molfetta ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Birth Outcomes ◽  
Low Income ◽  
Remote Monitoring ◽  
Financial Incentives ◽  
Intervention Group ◽  
Health Care Expenditures ◽  
Similar Reduction ◽  
Pregnant Smokers

Background Smoking rates among low-income individuals, including those eligible for Medicaid, have not shown the same decrease that is observed among high-income individuals. The rate of smoking among pregnant women enrolled in Medicaid is almost twice that among privately insured women, which leads to significant disparities in birth outcomes and a disproportionate cost burden placed on Medicaid. Several states have identified maternal smoking as a key target for improving birth outcomes and reducing health care expenditures; however, efficacious, cost-effective, and feasible cessation programs have been elusive. Objective This study aims to examine the feasibility, acceptability, and effectiveness of a smartwatch-enabled, incentive-based smoking cessation program for Medicaid-eligible pregnant smokers. Methods Pilot 1 included a randomized pilot study of smartwatch-enabled remote monitoring versus no remote monitoring for 12 weeks. Those in the intervention group also received the SmokeBeat program. Pilot 2 included a randomized pilot study of pay-to-wear versus pay-to-quit for 4 weeks. Those in a pay-to-wear program could earn daily incentives for wearing the smartwatch, whereas those in pay-to-quit program could earn daily incentives if they wore the smartwatch and abstained from smoking. Pilot 3, similar to pilot 2, had higher incentives and a duration of 3 weeks. Results For pilot 1 (N=27), self-reported cigarettes per week among the intervention group declined by 15.1 (SD 27) cigarettes over the study; a similar reduction was observed in the control group with a decrease of 17.2 (SD 19) cigarettes. For pilot 2 (N=8), self-reported cigarettes per week among the pay-to-wear group decreased by 43 cigarettes (SD 12.6); a similar reduction was seen in the pay-to-quit group, with an average of 31 (SD 45.6) fewer cigarettes smoked per week. For pilot 3 (N=4), one participant in the pay-to-quit group abstained from smoking for the full study duration and received full incentives. Conclusions Decreases in smoking were observed in both the control and intervention groups during all pilots. The use of the SmokeBeat program did not significantly improve cessation. The SmokeBeat program, remote cotinine testing, and remote delivery of financial incentives were considered feasible and acceptable. Implementation challenges remain for providing evidence-based cessation incentives to low-income pregnant smokers. The feasibility and acceptability of the SmokeBeat program were moderately high. Moreover, the feasibility and acceptability of remote cotinine testing and the remotely delivered contingent financial incentives were successful. Trial Registration ClinicalTrials.gov NCT03209557; https://clinicaltrials.gov/ct2/show/NCT03209557.

scholarly journals Remote Patient Monitoring and Incentives to Support Smoking Cessation Among Pregnant and Postpartum Medicaid Members: Three Randomized Controlled Pilot Studies (Preprint)

2021 ◽  
Author(s):  
Caroline M Joyce ◽  
Kathryn Saulsgiver ◽  
Salini Mohanty ◽  
Chethan Bachireddy ◽  
Carin Molfetta ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Birth Outcomes ◽  
Low Income ◽  
Remote Monitoring ◽  
Financial Incentives ◽  
Intervention Group ◽  
Health Care Expenditures ◽  
Similar Reduction ◽  
Pregnant Smokers

BACKGROUND Smoking rates among low-income individuals, including those eligible for Medicaid, have not shown the same decrease that is observed among high-income individuals. The rate of smoking among pregnant women enrolled in Medicaid is almost twice that among privately insured women, which leads to significant disparities in birth outcomes and a disproportionate cost burden placed on Medicaid. Several states have identified maternal smoking as a key target for improving birth outcomes and reducing health care expenditures; however, efficacious, cost-effective, and feasible cessation programs have been elusive. OBJECTIVE This study aims to examine the feasibility, acceptability, and effectiveness of a smartwatch-enabled, incentive-based smoking cessation program for Medicaid-eligible pregnant smokers. METHODS Pilot 1 included a randomized pilot study of smartwatch-enabled remote monitoring versus no remote monitoring for 12 weeks. Those in the intervention group also received the SmokeBeat program. Pilot 2 included a randomized pilot study of pay-to-wear versus pay-to-quit for 4 weeks. Those in a pay-to-wear program could earn daily incentives for wearing the smartwatch, whereas those in pay-to-quit program could earn daily incentives if they wore the smartwatch and abstained from smoking. Pilot 3, similar to pilot 2, had higher incentives and a duration of 3 weeks. RESULTS For pilot 1 (N=27), self-reported cigarettes per week among the intervention group declined by 15.1 (SD 27) cigarettes over the study; a similar reduction was observed in the control group with a decrease of 17.2 (SD 19) cigarettes. For pilot 2 (N=8), self-reported cigarettes per week among the pay-to-wear group decreased by 43 cigarettes (SD 12.6); a similar reduction was seen in the pay-to-quit group, with an average of 31 (SD 45.6) fewer cigarettes smoked per week. For pilot 3 (N=4), one participant in the pay-to-quit group abstained from smoking for the full study duration and received full incentives. CONCLUSIONS Decreases in smoking were observed in both the control and intervention groups during all pilots. The use of the SmokeBeat program did not significantly improve cessation. The SmokeBeat program, remote cotinine testing, and remote delivery of financial incentives were considered feasible and acceptable. Implementation challenges remain for providing evidence-based cessation incentives to low-income pregnant smokers. The feasibility and acceptability of the SmokeBeat program were moderately high. Moreover, the feasibility and acceptability of remote cotinine testing and the remotely delivered contingent financial incentives were successful. CLINICALTRIAL ClinicalTrials.gov NCT03209557; https://clinicaltrials.gov/ct2/show/NCT03209557.

Emotion Regulation Difficulties and Social Control Correlates of Smoking among Pregnant Women Trying to Quit

2018 ◽  
Author(s):  
Jennifer Fillo ◽  
Kimberly E. Kamper-DeMarco ◽  
Whitney C. Brown ◽  
Paul R. Stasiewicz ◽  
Clara M. Bradizza
Keyword(s):  
Smoking Cessation ◽  
Emotion Regulation ◽  
Negative Affect ◽  
Social Control ◽  
Pregnant Women ◽  
Nicotine Dependence ◽  
Low Income ◽  
Withdrawal Symptoms ◽  
Smoking During Pregnancy ◽  
Pregnant Smokers

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence.

scholarly journals Smartphone-Based Financial Incentives to Promote Smoking Cessation During Pregnancy: A Pilot Study

2020 ◽  
Vol 75 (12) ◽  
pp. 713-714
Author(s):  
Allison N. Kurti ◽  
Katherine Tang ◽  
Hypatia A. Bolivar ◽  
Carolyn Evemy ◽  
Norman Medina ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Financial Incentives ◽  
Promote Smoking Cessation

scholarly journals Automated Mobile Delivery of Financial Incentives for Smoking Cessation among Socioeconomically Disadvantaged Adults: A Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Darla E. Kendzor ◽  
Michael S. Businelle ◽  
Joseph J. C. Waring ◽  
Ashley Mathews ◽  
Daryl W. Geller ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentives ◽  
Credit Card ◽  
Facial Recognition ◽  
Smoking Status ◽  
Telephone Counseling ◽  
Socioeconomically Disadvantaged ◽  
Annual Household Income ◽  
Cessation Treatment

BACKGROUND Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment within socioeconomically disadvantaged populations. OBJECTIVE The purpose of this project was to develop and test the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. METHODS Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from one week before a scheduled quit attempt through 26 weeks after the quit date. All participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified five times per week via smartphone prompts to complete a smoking status assessment and submit a breath sample with a portable breath carbon monoxide monitor that connects with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first four weeks after the scheduled quit date, with additional incentives offered at post-quit weeks eight and 12. RESULTS Participants (N = 16) were predominantly female (75.00%) and non-Hispanic White (68.75%) or Black (25.00%), or Hispanic of any race (6.25%). Most participants (56.25%) reported an annual household income of < $11,000. During the first four weeks after the scheduled quit date, participants were abstinent on 29.46% of days, they completed an average of 68.45% of mobile smoking status assessments. Participants earned an average of $37.56 during the first four weeks post-quit, with an additional $5.00 and $3.00 earned on average during post-quit weeks eight and 12 respectively (M = $45.56 total). Over the 12-week incentive period, 48.58% of facial recognition assessments worked as expected. At the in-person follow-up visits, CO-confirmed 7-day point prevalence abstinence rates were 18.75% and 12.50% at 12 and 26 weeks post-quit-date, respectively. Notably, all feasibility metrics improved between the first half of participants enrolled and the latter half, which suggests improved intervention delivery over time. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. CONCLUSIONS Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status, and automating the delivery of abstinence-contingent incentives to a credit card may be feasible for use among socioeconomically disadvantaged adults. CLINICALTRIAL This study is registered at www.clinicaltrials.gov (NCT03517397).

scholarly journals The effect of a fresh produce incentive paired with cooking and nutrition education on healthy eating in low-income households: a pilot study

2021 ◽  
pp. 1-11
Author(s):  
Angela R Fertig ◽  
Xuyang Tang ◽  
Heather M Dahlen
Keyword(s):  
Pilot Study ◽  
Nutrition Education ◽  
Healthy Eating ◽  
Low Income ◽  
Financial Incentives ◽  
Fruits And Vegetables ◽  
Vegetable Consumption ◽  
Financial Incentive ◽  
Future Research ◽  
Control Group

Abstract Objective: This study pilot-tested combining financial incentives to purchase fruits and vegetables with nutrition education focused on cooking to increase the consumption of fruits and vegetables and improve attitudes around healthy eating on a budget among low-income adults. The goal of the pilot study was to examine implementation feasibility and fidelity, acceptability of the intervention components by participants and effectiveness. Design: The study design was a pre-post individual-level comparison without a control group. The pilot intervention included two components, a scan card providing free produce up to a weekly maximum dollar amount for use over a 2-month period, and two sessions of tailored nutrition and cooking education. Outcomes included self-reported attitudes about healthy eating and daily fruit and vegetable consumption from one 24-h dietary recall collected before and after the intervention. Setting: Greater Minneapolis/St. Paul area in Minnesota. Participants: Adults (n 120) were recruited from five community food pantries. Results: Findings indicated that the financial incentive component of the intervention was highly feasible and acceptable to participants, but attendance at the nutrition education sessions was moderate. Participants had a statistically significant increase in the consumption of fruit, from an average of 1·00 cup/d to 1·78 cups/d (P < 0·001), but no significant change in vegetable consumption or attitudes with respect to their ability to put together a healthy meal. Conclusions: While combining financial incentives with nutrition education appears to be acceptable to low-income adult participants, barriers to attend nutrition education sessions need to be addressed in future research.

scholarly journals Financial incentives for smoking cessation in pregnancy: multicentre randomised controlled trial

BMJ ◽  
2021 ◽  
pp. e065217
Author(s):  
Ivan Berlin ◽  
Noémi Berlin ◽  
Marie Malecot ◽  
Martine Breton ◽  
Florence Jusot ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Confidence Interval ◽  
Financial Incentives ◽  
Odds Ratio ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Abstinence Rate ◽  
Control Group ◽  
Smoking Abstinence ◽  
Pregnant Smokers

AbstractObjectiveTo evaluate the efficacy of financial incentives dependent on continuous smoking abstinence on smoking cessation and birth outcomes among pregnant smokers.DesignSingle blind, randomised controlled trial.SettingFinancial Incentive for Smoking Cessation in Pregnancy (FISCP) trial in 18 maternity wards in France.Participants460 pregnant smokers aged at least 18 years who smoked ≤5 cigarettes/day or ≤3 roll-your-own cigarettes/day and had a pregnancy gestation of <18 weeks were randomised to a financial incentives group (n=231) or a control group (n=229).InterventionsParticipants in the financial incentives group received a voucher equivalent to €20 (£17; $23), and further progressively increasing vouchers at each study visit if they remained abstinent. Participants in the control group received no financial incentive for abstinence. All participants received a €20 show-up fee at each of six visits.Main outcome measuresThe main outcome measure was continuous smoking abstinence from the first post-quit date visit to visit 6, before delivery. Secondary outcomes in the mothers were point prevalence abstinence, time to smoking relapse, withdrawal symptoms, blood pressure, and alcohol and cannabis use in past 30 days. Secondary outcomes in the babies were gestational age at birth, birth characteristics (birth weight, length, head circumference, Apgar score), and a poor neonatal outcome—a composite measure of transfer to the neonatal unit, congenital malformation, convulsions, or perinatal death.ResultsMean age was 29 years. In the financial incentives and control groups, respectively, 137 (59%) and 148 (65%) were employed, 163 (71%) and 171 (75%) were in a relationship, and 41 (18%) and 31 (13%) were married. The participants had smoked a median of 60 cigarettes in the past seven days. The continuous abstinence rate was significantly higher in the financial incentives group (16%, 38/231) than control group (7%, 17/229): odds ratio 2.45 (95% confidence interval 1.34 to 4.49), P=0.004). The point prevalence abstinence rate was higher (4.61, 1.41 to 15.01, P=0.011), the median time to relapse was longer (visit 5 (interquartile range 3-6) and visit 4 (3-6), P<0.001)), and craving for tobacco was lower (β=−1.81, 95% confidence interval −3.55 to −0.08, P=0.04) in the financial incentives group than control group. Financial incentives were associated with a 7% reduction in the risk of a poor neonatal outcome: 4 babies (2%) in the financial incentives group and 18 babies (9%) in the control group: mean difference 14 (95% confidence interval 5 to 23), P=0.003. Post hoc analyses suggested that more babies in the financial incentives group had birth weights ≥2500 g than in the control group: unadjusted odds ratio 1.95 (95% confidence interval 0.99 to 3.85), P=0.055; sex adjusted odds ratio 2.05 (1.03 to 4.10), P=0.041; and sex and prematurity adjusted odds ratio 2.06 (0.90 to 4.71), P=0.086. As these are post hoc analyses, the results should be interpreted with caution.ConclusionsFinancial incentives to reward smoking abstinence compared with no financial incentives were associated with an increased abstinence rate in pregnant smokers. Financial incentives dependent on smoking abstinence could be implemented as a safe and effective intervention to help pregnant smokers quit smoking.Trial registrationClinicalTrials.gov NCT02606227.

scholarly journals Exploring Efficacy of a Serious Game (Tobbstop) for Smoking Cessation During Pregnancy: Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Francesc X Marin-Gomez ◽  
Rocio Garcia-Moreno Marchán ◽  
Anabel Mayos-Fernandez ◽  
Gemma Flores-Mateo ◽  
Esther Granado-Font ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Tobacco Use ◽  
Controlled Trial ◽  
Intervention Group ◽  
Serious Game ◽  
Control Group ◽  
Randomized Controlled ◽  
Pregnant Smokers

BACKGROUND Tobacco use during pregnancy entails a serious risk to the mother and harmful effects on the development of the child. Europe has the highest tobacco smoking prevalence (19.3%) compared with the 6.8% global mean. Between 20% to 30% of pregnant women used tobacco during pregnancy worldwide. These data emphasize the urgent need for community education and implementation of prevention strategies focused on the risks associated with tobacco use during pregnancy. OBJECTIVE The aim of this study was to investigate the efficacy of an intervention that incorporates a serious game (Tobbstop) to help pregnant smokers quit smoking. METHODS A two-arm randomized controlled trial enrolled 42 women who visited 2 primary care centers in Catalonia, Spain, between March 2015 and November 2016. All participants were pregnant smokers, above 18 years old, attending consultation with a midwife during the first trimester of pregnancy, and had expressed their desire to stop smoking. Participants were randomized to the intervention (n=21) or control group (n=21). The intervention group was instructed to install the game on their mobile phone or tablet and use it for 3 months. Until delivery, all the participants were assessed on their stage of smoking cessation during their follow-up midwife consultations. The primary outcome was continuous tobacco abstinence until delivery confirmed by the amount of carbon monoxide at each visit, measured with a carboxymeter. RESULTS Continuous abstinence until delivery outcome was 57% (12/21) in the intervention group versus 14% (3/21) in the control group (hazard ratio=4.31; 95% CI 1.87-9.97; P=.001). The mean of total days without smoking until delivery was higher in the intervention group (mean 139.75, SD 21.76) compared with the control group (mean 33.28, SD 13.27; P<.001). In addition, a Kapplan-Meier survival analysis showed that intervention group has a higher abstinence rate compared with the control group (log-rank test, χ21=13.91; P<.001). CONCLUSIONS Serious game use is associated with an increased likelihood to maintain abstinence during the intervention period if compared with those not using the game. Pregnancy is an ideal opportunity to intervene and control tobacco use among future mothers. On the other hand, serious games are an emerging technology, growing in importance, which are shown to be a good tool to help quitting smoking during pregnancy and also to maintain this abstinent behavior. However, because of the study design limitations, these outcomes should be interpreted with caution. More research, using larger samples and longer follow-up periods, is needed to replicate the findings of this study. CLINICALTRIAL ClinicalTrials.gov NCT01734421; https://clinicaltrials.gov/ct2/show/NCT01734421 (Archived by WebCite at http://www.webcitation.org/75ISc59pB)

scholarly journals Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial

2018 ◽  
Vol 21 (8) ◽  
pp. 1426-1434 ◽  
Author(s):  
Rebecca L Franckle ◽  
Douglas E Levy ◽  
Lorena Macias-Navarro ◽  
Eric B Rimm ◽  
Anne N Thorndike
Keyword(s):  
Randomized Controlled Trial ◽  
Low Income ◽  
Financial Incentives ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Traffic Light ◽  
Sugar Sweetened Beverages ◽  
Randomized Controlled ◽  
Sweetened Beverages

AbstractObjectiveThe objective of the present study was to test the effectiveness of financial incentives and traffic-light labels to reduce purchases of sugar-sweetened beverages in a community supermarket.DesignIn this randomized controlled trial, after a 2-month baseline period (February–March 2014), in-store traffic-light labels were posted to indicate healthy (green), less healthy (yellow) or unhealthy (red) beverages. During the subsequent five months (April–August 2014), participants in the intervention arm were eligible to earn a $US 25 in-store gift card each month they refrained from purchasing red-labelled beverages.SettingUrban supermarket in Chelsea, MA, USA, a low-income Latino community.SubjectsParticipants were customers of this supermarket who had at least one child living at home. A total of 148 customers (n 77 in the intervention group and n 71 in the control group) were included in the final analyses.ResultsOutcomes were monthly in-store purchases tracked using a store loyalty card and self-reported consumption of red-labelled beverages. Compared with control participants, the proportion of intervention participants who purchased any red-labelled beverages decreased by 9 % more per month (P=0·002). More intervention than control participants reduced their consumption of red-labelled beverages (−23 % v. −2 % for consuming ≥1 red beverage/week, P=0·01).ConclusionsOverall, financial incentives paired with in-store traffic-light labels modestly reduced purchase and consumption of sugar-sweetened beverages by customers of a community supermarket.

scholarly journals Mobile Delivery of Mindfulness-Based Smoking Cessation Treatment Among Low-Income Adults During the COVID-19 Pandemic: Pilot Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Josephine Mhende ◽  
Sharrill A Bell ◽  
Cherell Cottrell-Daniels ◽  
Jackie Luong ◽  
Micah Streiff ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
African American ◽  
Pilot Study ◽  
Low Income ◽  
Text Messaging ◽  
Addiction Treatment ◽  
Underserved Populations ◽  
Text Messages ◽  
Internet Survey ◽  
The Internet

BACKGROUND Smoking is the leading cause of premature death, and low-income adults experience disproportionate burden from tobacco. Mindfulness interventions show promise for improving smoking cessation. A text messaging program “iQuit Mindfully” was developed to deliver just-in-time support for quitting smoking among low-income adults. A pilot study of iQuit Mindfully was conducted in spring 2020, during the COVID-19 pandemic, among low-income and predominantly African American smokers. OBJECTIVE This pilot study examined the acceptability and feasibility of delivering Mindfulness-Based Addiction Treatment via mHealth during the COVID-19 pandemic. METHODS Participants were adult cigarette smokers (n=23), of whom 8 (34.8%) were female, 19 (82.6%) were African American, and 18 (78.3%) had an annual income of &lt;US $24,000. They were randomly assigned to either 8 weeks of iQuit Mindfully as a fully automated standalone intervention or iQuit Mindfully in combination with therapist-led in-person group treatment. For participant safety, in-person mindfulness groups were transitioned to the internet and assessments also took place over the internet. Survey questions asked participants about changes in their stress, smoking habits and quit attempts, and their perceptions of the mindfulness and text messaging intervention in the context of the pandemic. RESULTS Most participants (n=15 of 21, 71.4%) indicated a change in stress due to the pandemic, of whom 14 (93.3%) indicated higher stress. Participants shared concerns about finances, homelessness, health, and social isolation. Most (n=17 of 21, 80.9%) believed that smoking increases the risk of contracting COVID-19, and although that was motivating for some, others expressed lower motivation to quit smoking because of higher stress. Most (n=18 of 21, 85.7%) stated that practicing mindfulness was helpful during the pandemic. Mean ratings of the helpfulness of text messages and the extent to which they would recommend the program to others were 7.1 (median 8 on a 10-point scale, SD 2.9) and 8.2 (median 9, SD 2.5), respectively. Through open-ended program evaluations, participants shared details about how mindfulness practices and the text messages helped them manage stress and feel a sense of social support during the pandemic. Moreover, 10 of 19 (52.6%) of participants achieved 7-day abstinence from smoking, with no differences between conditions. CONCLUSIONS This study supports the promise of text messaging and the use of teleconferencing to provide mindfulness and smoking cessation services to underserved populations during a pandemic.

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