TSET HPRC Researcher Receives Federal Grant to Help Low-Income Oklahomans Quit Smoking

Darla Kendzor, Ph.D., co-director of the TSET Health Promotion Research Center, was recently awarded a 5-year, $3.1 million grant from the National Cancer Institute to evaluate the effectiveness of an automated, smartphone-based approach to incentivizing smoking cessation among low-income adults in Oklahoma.

Kendzor's past work has uncovered the detrimental impact that financial stress, neighborhood problems, and discrimination can have on smoking cessation. Recently, her work has focused on developing and evaluating practical and effective smoking cessation interventions for vulnerable Oklahomans.

Lung cancer, primarily caused by smoking, is the leading cause of cancer death in the U.S. and is far more prevalent among lower income adults. Kendzor and others have shown that offering small monetary incentives for quitting smoking can dramatically increase smoking cessation rates among socioeconomically disadvantaged adults, especially when incentives are paired with clinic-based treatment. However, many adults are unable or unwilling to attend regular clinic visits, particularly those who live in rural areas; thus, innovative approaches are needed to reach people outside of the clinic setting.

"My team has developed an automated, smartphone-based approach to rewarding smoking cessation that will allow us to reach people across the state with an effective intervention, regardless of their proximity to the clinic," Kendzor explained. "Our hope is that this treatment will help to reduce the high rate of smoking in Oklahoma and prevent tobacco-related diseases."

This study will enroll 532 low-income Oklahomans. Participants will be randomly assigned to either standard care - telephone counseling and mailed nicotine patches/lozenges - or standard care plus monetary payments for abstinence. All participants will be followed from one week before quitting, through 26 weeks after the quit date to determine the longer-term impact of the intervention on smoking cessation. No office visits are required, since all participants will receive counseling by telephone and nicotine replacement therapy by mail.

"Our smartphone app will ask participants to provide breath samples to verify smoking abstinence, and facial recognition software will be used to verify participant identity when they provide breath samples," said Kendzor. Incentives will be automatically added to the participant's reloadable credit card when smoking abstinence and identity are verified. The cost-effectiveness of this approach will be evaluated to determine whether this approach should be disseminated throughout the United States via smoking cessation helplines and other venues.

This innovative study could increase the reach of a potentially effective and cost-effective smoking cessation intervention to those who need it most. To find more information about the study, call (405) 271-QUIT or visit 271quit.com

This research was primarily supported by National Cancer Institute (NCI) grant R01CA251451 (to D.E. Kendzor). Additional support was provided by Oklahoma Tobacco Settlement Endowment Trust Grant R21-02, and the Mobile Health Technology Shared Resource, which is a component of the NCI Cancer Center Support Grant P30CA225520 awarded to the Stephenson Cancer Center.