Culturally sensitive, evidence-based, Spanish language mobile app for smoking cessation for Latino cigarette smokers

Cigarette smoking is the leading cause of mortality in the U Sresulting in overdeaths every year and costing more than $billion in loss of productivitySmoking is also the leading cause of cancer and of deaths from cancerAlthough the prevalence of smoking has declined over the pastyearslarge disparities in tobacco use remain across a number of groupsLatino a smokers represent a major health disparity population in the U Sand their unique healthcare needs are not being adequately addressedMajor contributing factors to smoking among Latinos in the U Sinclude increased exposure to multiple stressors associated with crime and unemploymentelevated rates of anxiety depressiondiscriminationlack of Spanish language treatmentsand limited access to quality careAlthough Latino smokers tend to smoke at lower rates than non Latino Whites and are more likely than non Latino White smokers to attempt cessationthey are less likely to receive in person evidence based care and more apt to fail in their quit attemptsMobile technologies offer an ideal strategy to meet the widespread treatment needs of U SLatino a smokersas U Spopulation data suggests that Latinos adopt smartphones at a rate higher than any other demographic groupHoweverthere are currently no Spanish language mobile apps for Latino smokers that are psychosocial in nature and evidence based for Latino smokers who often struggle with elevated rates of anxiety depression and chronic exposure to life stressorse gdiscriminationacculturationOne cognitivebehavior therapy that is an ideal fit for this need and is particularly amenable to a mobile platform is anxiety sensitivity reduction based smoking cessationAnxiety sensitivityASis a cognitive construct reflecting a disproportionate fear of anxiety related sensationsIndividuals with high AS interpret stress related sensationse gheart palpitationsas personally harmful or dangerousThere is a substantial literature linking AS to the development of anxiety and depressive disordersPTSDand substance use disordersMoreoverAS is related to increased risk for smoking cessation failure and more severe withdrawal craving among smokersincluding LatinosReducing AS prior to a quit attempt via cognitive restructuring and interoceptive exposure is related to increased success in quittingOur team has previously adapted AS reduction for smoking in Spanish and results from this work suggest that a Spanish language version of AS reduction for smoking cessation is effective for increasing smoking cessation success and reducing negative mood that impairs quit attemptsThe aims of this Phase I application are to employ user centered design to develop and test the acceptability and efficacy of a Spanish languagemobile appImpactowhich will incorporate proven AS reduction intervention strategies vsa genericSpanish language control smoking cessation appDejar de Fumar Asistentein a small randomized controlled trial of adult Latino smokersWe expect that this project will result in a prototype of Impactowhose clinical efficacy can then be tested in a fully poweredPhase II randomized controlled trial PUBLIC HEALTH RELEVANCEWhile the prevalence of cigarette smoking has declined over the pastyearslarge disparities in tobacco use remain across a number of groupsLatino a smokers represent a major health disparity population in the U Sand their unique healthcare needs are not being adequately addressedAnxiety sensitivityASis a cognitive construct reflecting a disproportionate fear of anxiety related sensations and is related to increased risk for smoking cessation failure and more severe withdrawal craving among smokersincluding LatinosThe proposed study will develop and test the feasibilityacceptability and preliminary efficacy of a Spanish languagemobile phone applicationnamed Impactowhich will incorporate proven AS reduction strategiesand thus will address a significant public health prioritythe development of newinnovative and efficacious approaches to smoking cessation treatment for Latino a smokers