Applying mHealth to Tobacco-related Health Disparities

Investigators will provide participants with nicotine patches, smoking cessation treatment
that will include brief counseling sessions (10-15 minutes each), and text messages sent to
their provided study phone throughout the day. These messages will be short (1-3 minutes
long) and will ask participants to do things like focus on the present moment, pay attention
to their breathing, and be aware of their current thoughts. Participants will be asked to
wear equipment throughout the day that will measure their physiology and smoking behavior.
Mobile Health (mHealth) is a general term for the use of mobile phones and other wireless
technology in medical care.

The key outcome and hypothesized mechanisms (i.e., lapse and stress) will be measured
objectively and automatically using AutoSense. AutoSense is a type of human sensing
technology that allows investigators to detect smoking behavior and stress objectively
through a chest strap and wrist bands worn by participants. Ecological momentary assessment
(EMA) will assess acute precipitants such as negative affect, craving, self-efficacy,
motivation, alcohol consumption, etc. Questionnaires will assess other predictors and
mechanisms.

Inclusion Criteria:

- Smoked a minimum of 3 cigarettes per day over the past year

- Expired carbon monoxide reading ≥ 6

- Motivated to quit within the next 30 days

- Valid home address

- Functioning telephone number

- Can speak, read, and write in English

- At least marginal health literacy

Exclusion Criteria:

- Contraindication for the nicotine patch (e.g., heart attack, angina, skin allergies)
unless a doctor's note is provided

- Endorse current psychosis

- Have a pacemaker or implanted device

- Physically unable to wear equipment and provide a good reading of physiological
measures

- Current use of tobacco cessation medications, involvement in a smoking program or
currently trying to quit

- Pregnancy or lactation

- Another household member being enrolled in the study

- No prior experience with a smart phone

- The study staff or principal investigator (PI) have serious concerns about the
participant's ability to engage in and/or complete the study protocol.