ASHES: Assessing Smoking BeHavior with ThErmal Sensing to Prevent Relapse

PROJECT SUMMARY Despite significant advancements in the treatment of tobacco dependence, up to 60% of individuals receiving treatment are not able to achieve cessation. Among the smoking population, cancer survivors are of particular concern, as continued smoking after diagnosis increases cancer treatment-related toxicity and risk of recurrence. Up to 84.4% of cancer survivors relapse under current treatments. Treatments integrating wearable technology to monitor an individual’s unique smoking behavior and smoking-related triggers in the natural environment can improve outcomes by providing the clinical information needed to anticipate lapses. Smoking topography, the physical characteristics of smoking behavior, quantifies the motivational drive to smoke and predicts abstinence following treatment. Existing methods of measuring topography require smokers to attach the cigarette to a device and smoke through a mouthpiece, making it infeasible to capture natural smoking behavior. The SmokeMon wearable designed by our team, however, detects and measures smoking behavior unobtrusively. Integration with ecological momentary assessment (EMA) of smoking triggers via smartphone app could optimize understanding of individuals’ smoking motivations and smoking triggers prior to quitting, enabling us to predict lapses and deliver just-in-time interventions to prevent them. This project evaluates the feasibility of SmokeMon for detecting smoking topography among cancer survivors and assessing its clinical utility for determining smoking motivation, smoking exposure, the strength of smoking triggers, and for predicting smoking lapses. In Study 1, 25 cancer survivors who are daily smokers will complete a one-week pre-quit observation period and a four-week post-quit observation period while wearing the SmokeMon device and responding to scheduled and random EMAs using the SmokeMon smartphone app each day across the two observation periods. Data will be used during post-quit to build models that predict lapses using pre-quit urge intensity and associated triggers. In Study 2, smoking cessation treatment providers will interact with and give feedback on SmokeDash, a clinician- facing portal developed by SenseWhy, Inc. to aggregate SmokeMon and EMA data and present them to providers in a helpful, intuitive format. Feedback solicited from treatment providers during Study 2 will inform future design iterations of the SmokeDash software. This Phase 1 SBIR project will produce a feasible and clinically meaningful system for remote monitoring of smoking behavior and intervention, a software suite optimized to the needs and preferences of cessation treatment providers, and an enhanced set of tools that improve the study of smoking behaviors in general. This project lays the groundwork for a Phase 2 project to assess the effectiveness of a treatment program with a larger sample size. SmokeMon is currently aiming to commercialize among the 52 NCI-funded cancer centers, and future research by SenseWhy, Inc. will expand SmokeMon to alternative nicotine products such as electronic cigarettes and heated tobacco devices.