Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial

Introduction Smoking in pregnancy negatively impacts the mother’s and offspring’s health. Mobile health, especially mobile phone-based approaches, shows promise in supporting pregnant women to quit smoking. Our previous research indicated that support from laypersons, such as family, friends and cow...

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Main Authors: Ken Resnicow, Kristie Foley, Daniel Muresan, Oana M Blaga, Marina D Dascal, Alexandra Onișor, Teodora Frățilă, Andreea Morar, Dan Mihu, Cristian I Iuhas, Gabriela Caracostea, Cristian I Meghea
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e100259.full
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author Ken Resnicow
Kristie Foley
Daniel Muresan
Oana M Blaga
Marina D Dascal
Alexandra Onișor
Teodora Frățilă
Andreea Morar
Dan Mihu
Cristian I Iuhas
Gabriela Caracostea
Cristian I Meghea
author_facet Ken Resnicow
Kristie Foley
Daniel Muresan
Oana M Blaga
Marina D Dascal
Alexandra Onișor
Teodora Frățilă
Andreea Morar
Dan Mihu
Cristian I Iuhas
Gabriela Caracostea
Cristian I Meghea
author_sort Ken Resnicow
collection DOAJ
description Introduction Smoking in pregnancy negatively impacts the mother’s and offspring’s health. Mobile health, especially mobile phone-based approaches, shows promise in supporting pregnant women to quit smoking. Our previous research indicated that support from laypersons, such as family, friends and coworkers, can increase smoking cessation. Building on these findings, we developed an innovative smartphone application (app) that combines the power of social support with artificial intelligence. The app leverages the unique functionality of smartphones and reinforcement learning (RL) to provide a deeply tailored intervention that continuously adapts while emphasising positive support through reciprocal interactions between the smoker and the support person. Herein, we report the methods used to develop, implement and test the feasibility and effectiveness of a novel adaptive mobile pregnancy tobacco cessation app-based intervention using deep tailoring and a self-nominated supporter.Methods and analysis The study is a type II hybrid effectiveness-implementation randomised controlled trial. In total, 300 pregnant smokers and their supporters will be randomised to (1) the SmokeFree Together 2.0 app and an RL-based intervention that continuously decides if a counselling call is needed using a fixed algorithm measuring motivation and craving or (2) a control group. The intervention will be administered throughout pregnancy up to 1 month after giving birth, with a 5-month follow-up period and outcome assessments at 3-month and 6-month post partum. Cessation (primary outcome) is defined as 7-day point biochemically verified prevalence of tobacco use and abstinence since birth, assessed at 6 months post partum. The central hypothesis is that the intervention will show evidence of feasibility and effectiveness in increasing social support, pregnancy cessation and postnatal abstinence.Ethics and dissemination The Institutional Review Board of Michigan State University (#IRB00000297) approved this trial. The findings will be disseminated through peer-reviewed publications and participation in scientific conferences.Trial registration number NCT05337722. Protocol version: 1.3 from 15.05.2024.
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spelling doaj-art-bf9949a3a2cd4700a5646472014726532025-08-20T02:10:33ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2025-100259Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trialKen Resnicow0Kristie Foley1Daniel Muresan2Oana M Blaga3Marina D Dascal4Alexandra Onișor5Teodora Frățilă6Andreea Morar7Dan Mihu8Cristian I Iuhas9Gabriela Caracostea10Cristian I Meghea11School of Public Health, University of Michigan, Ann Arbor, Michigan, USAWake Forest University School of Medicine, Winston-Salem, North Carolina, USAUniversitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, RomaniaDepartment of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, Michigan, USAUniversitatea Babes-Bolyai, Cluj-Napoca, RomaniaDepartment of Public Health, Universitatea Babes-Bolyai, Cluj-Napoca, RomaniaUniversitatea Babes-Bolyai, Cluj-Napoca, RomaniaUniversitatea Babes-Bolyai, Cluj-Napoca, RomaniaDepartment of Obstetrics and Gynaecology Dominic Stanca Clinic, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, RomaniaDepartment of Obstetrics and Gynaecology Dominic Stanca Clinic, Universitatea de Medicina si Farmacie Iuliu Hatieganu, Cluj-Napoca, RomaniaDepartment of Obstetrics and Gynecology, Medicover Hospital, Cluj-Napoca, RomaniaDepartment of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, East Lansing, Michigan, USAIntroduction Smoking in pregnancy negatively impacts the mother’s and offspring’s health. Mobile health, especially mobile phone-based approaches, shows promise in supporting pregnant women to quit smoking. Our previous research indicated that support from laypersons, such as family, friends and coworkers, can increase smoking cessation. Building on these findings, we developed an innovative smartphone application (app) that combines the power of social support with artificial intelligence. The app leverages the unique functionality of smartphones and reinforcement learning (RL) to provide a deeply tailored intervention that continuously adapts while emphasising positive support through reciprocal interactions between the smoker and the support person. Herein, we report the methods used to develop, implement and test the feasibility and effectiveness of a novel adaptive mobile pregnancy tobacco cessation app-based intervention using deep tailoring and a self-nominated supporter.Methods and analysis The study is a type II hybrid effectiveness-implementation randomised controlled trial. In total, 300 pregnant smokers and their supporters will be randomised to (1) the SmokeFree Together 2.0 app and an RL-based intervention that continuously decides if a counselling call is needed using a fixed algorithm measuring motivation and craving or (2) a control group. The intervention will be administered throughout pregnancy up to 1 month after giving birth, with a 5-month follow-up period and outcome assessments at 3-month and 6-month post partum. Cessation (primary outcome) is defined as 7-day point biochemically verified prevalence of tobacco use and abstinence since birth, assessed at 6 months post partum. The central hypothesis is that the intervention will show evidence of feasibility and effectiveness in increasing social support, pregnancy cessation and postnatal abstinence.Ethics and dissemination The Institutional Review Board of Michigan State University (#IRB00000297) approved this trial. The findings will be disseminated through peer-reviewed publications and participation in scientific conferences.Trial registration number NCT05337722. Protocol version: 1.3 from 15.05.2024.https://bmjopen.bmj.com/content/15/3/e100259.full
spellingShingle Ken Resnicow
Kristie Foley
Daniel Muresan
Oana M Blaga
Marina D Dascal
Alexandra Onișor
Teodora Frățilă
Andreea Morar
Dan Mihu
Cristian I Iuhas
Gabriela Caracostea
Cristian I Meghea
Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
BMJ Open
title Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
title_full Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
title_fullStr Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
title_full_unstemmed Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
title_short Smartphone intervention for pregnancy smoking cessation with peer support: the study protocol of the SmokeFree Together 2.0 (SFT 2.0) randomised controlled trial
title_sort smartphone intervention for pregnancy smoking cessation with peer support the study protocol of the smokefree together 2 0 sft 2 0 randomised controlled trial
url https://bmjopen.bmj.com/content/15/3/e100259.full
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