Can a combination of Quitline support, app-based incentives, and daily breath tests improve smoking cessation rates among menthol cigarette users?
RT’s Three Key Takeaways:
- A University of Michigan study will evaluate whether combining Quitline support with app-based incentives and daily breath tests improves smoking cessation rates among menthol cigarette users.
- The program targets populations disproportionately affected by menthol cigarette use—especially low-income and Black communities—with the goal of improving health equity and reducing Medicaid costs.
- Funded by PCORI, the study emphasizes real-world, patient-centered approaches and aims to deliver actionable insights on the long-term effectiveness of different smoking cessation strategies.
A University of Michigan study will test the best smoking cessation method for smokers of menthol cigarettes, which are the preferred type for nearly half of US smokers.
The five-year, multi-million dollar study, funded by the nonprofit Patient-Centered Outcomes Research Institute (PCORI), will work with 1,200 adults who smoke menthol cigarettes.
Half will receive motivational messages from an app along with the chance to get extra incentives to help them quit, if they submit daily breath tests. All participants will have access to coaching through partnership with state-run Quitlines.
With menthol cigarette use especially common among people with low incomes, the study could help reduce the financial toll of smoking on individuals and the Medicaid program that provides health coverage to low-income Americans.
People who smoke menthol are more likely to be Black, contributing to the extra risk of early death in Black men especially.
“With this funding support, we’ll have the chance to continue our work with the community to see how well the Tobacco Quitline support available to every American does at helping people quit menthol products, and also see the impact of an added incentive program that we’ve tested with our partners in Michigan,” said Lara Coughlin, Ph.D., an addiction psychologist at the U-M Addiction Center and the Michigan Medicine Department of Psychiatry. “Quitting menthol isn’t easy, but we hope to make it easier.”
Comparing Two Options to Support Quitting Menthols
Coughlin and Erin Bonar, Ph.D., also a U-M addiction psychologist, lead a team that developed the Incentives2Quit program, which combines a breath-analyzing carbon monoxide monitor and smartphone app with motivational messaging and small gift card incentives for hitting milestones in remaining tobacco-free. It’s already being used in pregnant women enrolled in Medicaid coverage in Michigan.
The team developed the program using the latest behavioral science. They decided to focus on menthol through conversations with community partners, because menthol cigarettes have mint flavorings that make smoking less irritating and enhance nicotine addiction, making them harder to quit.
They plan to recruit potential participants from people who call the Quitline program in five states and randomly assign those who enroll to receive a year of follow-up after that initial call or to receive the breath monitor and app with the chance to earn incentives for using Quitline coaches and hitting milestones.
Quitlines are available nationwide through free calls and texts, and web-based support. They can help people who smoke or vape any form of tobacco get access to counseling about quitting, as well as medicines and patches that can reduce nicotine cravings and are covered by most insurance programs.
The new project will test the long-term effectiveness of Quitline services, with or without the breath-testing incentive program. It will go beyond assessing impacts on participants’ smoking habits to also measure and compare impacts on their mental health, quality of life and other outcomes.
“Every attempt to quit smoking menthol cigarettes is a good start, but sustaining that over months is particularly key to reducing the health effects of tobacco,” said Coughlin. “Our study will provide evidence that could help states, Quitlines, insurance plans, and others use their resources wisely.”
