# An mHealth mood management tool to improve population-level tobacco cessation

> **NIH NIH R34** · FRED HUTCHINSON CANCER RESEARCH CENTER · 2021 · $90,494

## Abstract

PROJECT SUMMARY
Cigarette smoking is responsible for over 480,000 deaths annually in the US—three times higher than drug
overdose- and alcohol-related deaths combined—making cigarettes the most deadly drug of abuse. Although
smoking rates have declined over the past 50 years, tobacco use remains a critical problem. Depression
symptoms, which are highly prevalent among smokers making a quit attempt, reduce the odds of cessation by
50% and are not addressed in standard interventions. New methods for addressing depressive symptoms in
the context of a quit attempt are greatly needed. Behavioral activation therapy for depression (BAT-D) is a
novel addition to standard smoking cessation interventions that can address depressive symptoms as a risk
factor for treatment failure. Delivery through a mobile health application (mHealth app) makes this targeted
treatment available in a high-reach format, as apps for smoking cessation are downloaded over 1.6 million
times per year in the US alone. We conducted focus groups and individual user interviews to develop a limited
prototype of a BAT-D mood management app called Actify. We then evaluated it in a single-arm pilot trial,
which showed high engagement with the app (mean number of app logins=20), a promising short-term quit
rate of 31%, and a statistically and clinically significant reduction in depression symptoms. In this study, we
propose to refine the app based on single-arm pilot data, integrate smoking cessation content, conduct
usability testing, and evaluate the acceptability and efficacy of the completed app in a pilot randomized
controlled trial. In the first phase of the study, we will complete the development of Actify by adding cessation
content, refining the app structure to improve usability, and conducting additional prototype testing with a small
group of smokers (n=15). The second phase will be a pilot, randomized, controlled trial (n=240) comparing
Actify with QuitGuide, the National Cancer Institute’s mHealth app for smoking cessation, on (a) acceptability
(user satisfaction and number of app logins), (b) smoking abstinence (primary endpoint of 30-day point
prevalence abstinence at 8 weeks post-randomization), and (c) mechanisms of change (depressive symptoms
and change in behavioral activation). This study is significant in that addresses the important public health
problem of low quit rates and resultant tobacco-related health disparities among smokers experiencing mood
symptoms, and it builds off of a growing body of literature supporting the value of behavioral activation as a
component of cessation counseling. It is innovative in several key respects, including: (1) Actify is the first
standalone mHealth intervention of any kind to target depression and smoking cessation simultaneously; (2) it
is the first pilot trial of a standalone mHealth app to address depression as a barrier to quitting smoking; and,
(3) mHealth apps are a novel and promising addition to the larger body of mHea...

## Key facts

- **NIH application ID:** 10217089
- **Project number:** 5R34DA050967-02
- **Recipient organization:** FRED HUTCHINSON CANCER RESEARCH CENTER
- **Principal Investigator:** Jaimee Heffner
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $90,494
- **Award type:** 5
- **Project period:** 2020-08-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10217089

## Citation

> US National Institutes of Health, RePORTER application 10217089, An mHealth mood management tool to improve population-level tobacco cessation (5R34DA050967-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10217089. Licensed CC0.

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