Avatar-led digital health intervention for sexual and gender minority young adult smoking cessation: randomized controlled pilot trial.
Jaimee L Heffner, Kelsey Baker, Xinyi Fan et al.
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In 30 seconds
This randomized controlled pilot trial compared EQQUAL, an Acceptance and Commitment Therapy-based digital smoking cessation program tailored for sexual and gender minority (SGM) young adults, with Smokefree.gov. The 124 participants were aged 18–30 and smoked at least weekly; outcomes were assessed 3 months after randomization. Biochemically verified 7-day abstinence was 11.1% with EQQUAL versus 4.9% with Smokefree.gov (OR = 1.89, 95% CI = 0.45 to 9.66). Satisfaction was descriptively higher with EQQUAL, but readiness to quit, cigarettes per day, and theory-based change processes were similar between groups.
Key findings
- Biochemically verified 7-day point prevalence abstinence was 11.1% with EQQUAL versus 4.9% with Smokefree.gov (OR = 1.89, 95% CI = 0.45 to 9.66).
- Overall satisfaction was 68.8% with EQQUAL versus 60.0% with Smokefree.gov (OR = 1.17, 95% CI = 0.50 to 2.78).
- EQQUAL usability exceeded the acceptable benchmark score of 68, but participants completed an average of 1.4 of 6 digital sessions.
- Readiness to quit, cigarettes per day, and theory-based change-process outcomes were similar between groups.
Why it matters
SGM young adults face smoking cessation challenges, and accessible, culturally tailored support may help address this need. The pilot suggests that a tailored digital program can be acceptable and may have promising cessation outcomes compared with a general online program. However, the wide confidence interval and limited engagement mean the observed abstinence difference is preliminary rather than conclusive.
What to keep in mind
This was a pilot trial with 124 participants and outcomes assessed at 3 months; the abstinence estimate was imprecise, and average completion of EQQUAL sessions was low.