PROJECT SUMMARY This application is for an administrative supplement (PA-18-591) to NIDA-funded R34 grant “Social Media Intervention to Promote Smoking Treatment Utilization and Cessation among Alaska Native Smokers” (R34 DA46008). It is responsive to the NIDA notice of special Interest, NOT-DA-20-047 and meets the stated objective to understand the broad impacts of COVID-19 (e.g., anxiety, social isolation) on access to addiction treatment and substance use. The parent R34 grant is a Stage I treatment development grant to develop and pilot test a Facebook (FB) intervention for AN smokers statewide. With the advent of the COVID-19 pandemic, now more than ever, virtual options, such as social media, hold promise as sustainable and scalable intervention strategies to promote access to smoking cessation treatment among Alaska Native (AN) people, and other vulnerable and underserved health disparity groups who experience a disproportionate burden of tobacco-related morbidity/mortality and who may also be disproportionately affected by COVID-19. In this supplement, we propose to adapt and evaluate perceived effectiveness of new content for the FB intervention relevant to COVID-19 and smoking, using a rigorous participatory approach, as was done in developing other content. We will also collect data on self-reported impacts of COVID-19 on our outcomes of treatment utilization and cessation within our ongoing pilot clinical trial. Our Specific Aims (within the scope, timeline, and current evaluation process of the current R34) are to: 1) Assess the perceived effectiveness of social media content and communication on COVID-19 and smoking (N=40). We will use existing content on COVID-19 (e.g., CDC Tips™ campaign videos) for adaptation. Potential content adaptations for COVID-19 messaging that may impact treatment utilization and quitting as barriers or facilitators include stress, anxiety, perceived risks, social isolation, and social support; and 2) Explore the self-reported impact of COVID-19 perceived risks, severity, and COVID-related anxiety, stress, financial impacts, social isolation, and social support, on our primary outcome of smoking treatment utilization and cessation in our ongoing R34 pilot clinical trial (N=60) at 6-months follow-up. Our measures have been pilot tested and were selected from a bank of COVID-19 measures provided by the NIH. Expanding FB intervention content to address COVID-19 and evaluating COVID-19 impacts, within the parent R34 grant, is timely and significant. This work will provide the foundation for a larger Stage II efficacy trial.