Rowan psychology professor awarded NIH grant for smartphone-based smoking cessation intervention

Abstain from smoking, get virtual tokens to unlock your favorite apps. Puff away, and your smartphone applications stay locked. That’s the choice smokers attempting to quit will have when using Re-Connect, the smartphone-based smoking cessation intervention for which the National Institutes of Health awarded Dr. Bethany Raiff a three-year, $658,097grant.

Raiff, a Rowan University professor of psychology and director of the Health and Behavioral Integrated Treatments (HABIT) Research Unit, has been working in behavioral health and smoking cessation for more than 15 years. Her research uses the principles of contingency management by applying an incentive—traditionally, money—to encourage the individual to give up smoking.

While Raiff’s previous NIH-funded efforts to use contingency management in video games “suggest the feasibility of and interest in this intervention,” she said, the video game format is too limiting. Raiff’s Re-Connect project aims to broaden the scope of these digital contingency management interventions. She and her team are in the process of developing and testing an app, for which they already have a provisional patent, that will restrict access to apps on the user’s smartphone.

To prove they aren’t smoking, users provide a sample by breathing into a portable monitor, similar to a Breathalyzer, that detects carbon monoxide on the breath. An app uses the phone’s camera to verify who is giving the carbon monoxide sample. Raiff is partnering with the University of Kentucky for help developing an app and collecting samples.

Most people who smoke—about seven out of 10—want to quit. Too often, though, wanting to quit and successfully quitting are two different things.

“Using a nicotine patch doesn’t work for many smokers because it doesn’t address social factors, stress management and the other multifaceted reasons for smoking,” Raiff said.

In the case of contingency management interventions like Re-Connect, the incentive competes well against these other factors by tapping into “the things a person would rather do than smoking,” Raiff said. Users can also combine it with other interventions, from nicotine patches to alternative forms of stress management.

“Contingency management is a really powerful intervention,” Raiff said. “The challenge has been to make a model that is sustainable and scalable, overcoming that sticking point of the cost of using financial incentives so we can get that intervention out there.”

Raiff plans to eventually seek authorization from the Food and Drug Administration (FDA) for the intervention as a prescription digital therapeutic, which doctors could prescribe and health insurance plans would cover.  

Students’ work was critical to getting this grant funded, Raiff said. Caitlyn Upton, a 29-year-old Ph.D. student in clinical psychology from Fort Worth, Texas, collected pilot data and devoted her thesis to testing the intervention’s acceptability to users. 

“The project will hopefully offer a means of access to an effective intervention that the general population typically doesn't have access to,” said Upton, who came up with the name Re-Connect. “It was fun to be involved in the beginning stages of what will hopefully turn into a new intervention, and it taught me a lot about what that process takes.”

“Now that we’ve done the legwork to demonstrate how efficacious contingency management is in smoking cessation intervention,” Raiff said, “the next stage is dissemination.” Helping more people successfully quit smoking—which, Raiff noted, is “the No. 1 preventable cause of death”—is worth the long-term work of further testing and seeking FDA approval.