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Individuals with low socioeconomic status have disproportionately high smoking rates and greater difficulty quitting smoking. Efficiently connecting underserved smokers to effective tobacco cessation programs is crucial for disease prevention and the elimination of health disparities. Smartphone-based interventions have the potential to enhance the reach and efficacy of smoking cessation treatments targeting underserved smokers, but there is little efficacy data for these interventions. In this study, we will partner with a large, local hunger-relief organization to evaluate the efficacy and economic impact of a theoretically-based, fully-automated, and interactive smartphone-based smoking cessation intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study will consist of a 2-group randomized controlled trial. Participants (<jats:italic>N<\/jats:italic>\u2009=\u2009500) will be recruited from a network of food distribution centers in West Central Florida and randomized to receive either Standard Treatment (ST,<jats:italic>n<\/jats:italic>\u2009=\u2009250) or Automated Treatment (AT,<jats:italic>n<\/jats:italic>\u2009=\u2009250). ST participants will be connected to the Florida Quitline for telephone-based treatment and will receive a 10-week supply of nicotine replacement therapy (NRT; transdermal patches and lozenges). AT participants will receive 10\u2009weeks of NRT and a fully-automated smartphone-based intervention consisting of interactive messaging, images, and audiovisual clips. The AT intervention period will span 26\u2009weeks, with 12\u2009weeks of proactive content and 26\u2009weeks of on-demand access. ST and AT participants will complete weekly 4-item assessments for 26\u2009weeks and 3-, 6-, and 12-month follow-up assessments. Our primary aim is to evaluate the efficacy of AT in facilitating smoking abstinence. As secondary aims, we will explore potential mediators and conduct economic evaluations to assess the cost and\/or cost-effectiveness of ST vs. AT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The overall goal of this project is to determine if AT is better at facilitating long-term smoking abstinence than ST, the more resource-intensive approach. If efficacy is established, the AT approach will be relatively easy to disseminate and for community-based organizations to scale and implement, thus helping to reduce tobacco-related health disparities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Clinical Trials Registry<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05004662\">NCT05004662<\/jats:ext-link>. Registered August 13, 2021.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12889-022-12840-7","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T09:04:05Z","timestamp":1647939845000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of an automated smartphone-based smoking cessation intervention versus standard quitline-delivered treatment among underserved smokers: protocol for a randomized controlled trial"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-4459","authenticated-orcid":false,"given":"Jennifer I.","family":"Vidrine","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Chen Tina","family":"Shih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Businelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K.","family":"Sutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Stewart","family":"Hoover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherell","family":"Cottrell-Daniels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany Shorey","family":"Fennell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina E.","family":"Bowles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damon J.","family":"Vidrine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"12840_CR1","volume-title":"The health consequences of smoking\u201450 years of progress: a report of the surgeon general","author":"United States Department of Health and Human Services","year":"2014","unstructured":"United States Department of Health and Human Services. 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IRB# 00000971. The most recent continuing review was completed on June 16, 2021 (Protocol Version 2)<i>.<\/i> Informed consent will be obtained from participants. We have a waiver of written documentation of informed consent. Therefore, oral consent will be obtained from participants consenting via phone or in person. Additionally, if a participant reads the consent themselves via the REDCap database consent screen, this will constitute acknowledgment of consent (no e-signature). All data will be kept confidential and stored in a secured location on an institutional server, which is backed up daily. Only certain members of the study staff or others designated by the MPIs will have access to the study data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable because we will not collect or videos of participants in this study. Additionally, no details on individuals are reported within the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"563"}}