Smartphone-Based Smoking Cessation Intervention (OKquit) forOklahoma Tobacco Helpline Users:Protocol for a RandomizedControlled Trial

Background: Tobacco quitlines provide effective resources (eg, nicotine replacement therapy, smoking cessation counseling,and text and web-based support) for those who want to quit smoking in the United States. However, quitlines reach approximatelyonly 1%-3% of people who smoke each year. Novel, smartphone-based, and low-burden interventions that offer 24/7 access tosmoking cessation resources that are tailored to current readiness to quit may increase appeal, reach, and effectiveness of smokingcessation interventions. Objective: This study will examine the efficacy of OKquit, a low-burden smartphone-based app for smoking cessation. Methods: Approximately 500 people who smoke cigarettes and access the Oklahoma Tobacco Helpline (OTH) will be randomizedto receive standard OTH care (SC) or SC plus the novel OKquit smartphone app for smoking cessation (OKquit). All participantswill use a smartphone app to complete study surveys (ie, baseline, 27 weekly surveys, brief daily check-ins, and 27-week follow-up).Upon completion of daily check-ins and weekly surveys, participants will receive either trivia type messages (SC) or messagesthat are tailored to current readiness to quit smoking and currently experienced lapse triggers (OKquit). In addition, those assignedto receive the OKquit app will have access to on-demand smoking cessation content (eg, quit tips, smoking cessation medicationtips). It is hypothesized that participants assigned to OKquit will be more likely to achieve biochemically verified 7-day pointprevalence abstinence than those assigned to SC at 27 weeks post enrollment. In addition, participants who use more OTHresources (eg, more cessation coaching sessions completed) or more OKquit resources (eg, access more quit tips) will have greaterbiochemically verified smoking cessation rates. Results: Data collection began in September 2022 and final follow-ups are expected to be completed by May 2025. Conclusions: Data from this randomized controlled trial will determine whether the OKquit smartphone app combined withOTH care will increase smoking cessation rates over standard OTH care alone. If successful, OKquit could provide tailoredintervention content at a fraction of the cost of traditional interventions. Furthermore, this type of low-burden intervention mayoffer a way to reach underserved populations of adults who smoke and want to quit. Trial Registration: ClinicalTrials.gov NCT05539209; https://clinicaltrials.gov/study/NCT05539209