Research, Evidence & Insights
Behavioral science. Clinical research. Practical programs built for real-world use.
PREPARED BY: Deanna Waters, MA, LMHC, CTTS, CAIMHP
REVIEWED BY: Jo Masterson, MBA, RN
LAST REVIEWED: August 2026
2Morrow develops evidence-based digital behavioral health programs designed to help people make difficult, lasting changes. Our programs are grounded in behavioral science and informed by Acceptance and Commitment Therapy, or ACT, an approach that helps people respond differently to difficult thoughts, feelings, cravings, and urges while taking action guided by what matters most.
Our most established research foundation is in tobacco cessation, where the digital approach that informs 2Morrow’s current program was developed and evaluated through research in collaboration with Fred Hutchinson Cancer Center. Our growing body of research also includes NIH-funded work in chronic pain conducted in collaboration with the University of Washington School of Medicine.
2Morrow also applies its behavioral approach across programs addressing stress, mood, weight, sleep, and other health needs. This page emphasizes the areas supported by the strongest 2Morrow-specific published research.
Research at a Glance
2Morrow’s evidence base includes a Phase III randomized clinical trial in smoking cessation, NIH-funded peer-reviewed research in chronic pain, and collaborations with academic, health care, and public health organizations. The sections below distinguish clinical outcomes from feasibility and engagement findings so readers can understand what each study does and does not establish.
Scientific Foundation
Acceptance and Commitment Therapy focuses on psychological flexibility: the ability to make room for difficult internal experiences while continuing to take actions that support personal values and goals.
In tobacco cessation, this means helping people notice cravings, thoughts, emotions, and other smoking triggers without automatically acting on them. It also helps people connect quitting with the people, priorities, and experiences that make change personally meaningful.
The ACT-based intervention evaluated in the iCanQuit research taught participants to respond to smoking triggers with greater openness and awareness while staying connected to their values. The technology and behavioral approach developed through this research now inform tobacco cessation programs delivered through the 2Morrow platform.
ACT has also been studied across a wide range of health and behavioral applications. Explore the State of the ACT Evidence through the Association for Contextual Behavioral Science.
Independent Review and Industry Recognition
Industry Recognition
2Morrow was named to Newsweek and Statista’s World’s Best Digital Health Companies 2024 list in the Prevention category and was included in PharmaShots’ 20 Innovative Digital Therapeutics Companies of 2025.
Independent Review
2Morrow’s Breathe Bundle has earned the DiMe Seal in 2025, which evaluates digital health software across clinical evidence, usability and accessibility, privacy and security, and equity and inclusion.
Tobacco Cessation Research
A large randomized clinical trial with long-term follow-up
The Phase III iCanQuit randomized clinical trial was conducted by researchers at Fred Hutchinson Cancer Center and published in JAMA Internal Medicine in 2020. The study compared an ACT-based smoking cessation app with QuitGuide, an app developed by the National Cancer Institute and based on U.S. clinical practice guidelines.
What is iCanQuit?
iCanQuit was the research app evaluated in the Phase III randomized clinical trial conducted by Fred Hutchinson Cancer Center; SmartQuit was an earlier version. 2Morrow first partnered with Fred Hutch in 2012 to help translate Fred Hutch’s Acceptance and Commitment Therapy-based smoking cessation program into a mobile app for research.
2Morrow collaborated on the development and research of the tobacco cessation program and holds an exclusive license to commercialize the technology developed through the Fred Hutch research. The iCanQuit® name is used for research purposes and is owned by the original researcher.
Fred Hutch has continued the research, while 2Morrow developed the real-world program now delivered through 2Morrow Health. The research app and the current 2Morrow program share the same ACT-based foundation, although features and implementation may differ from the versions studied.
Phase III Smoking Cessation Trial at a Glance
2,415
Adults enrolled in the randomized clinical trial.
34.2%
Seven-day abstinence at 12 months for participants using the ACT-based app.
1.49× the odds
Odds of achieving 30-day abstinence at 12 months with the ACT-based app.
87.2%
Participant retention at the 12-month follow-up.
The trial’s primary outcome, 30-day abstinence at 12 months, was 28.2% for participants using the ACT-based app compared with 21.1% for those using QuitGuide.
“The size of the quitting effect and the difference between the ACT app and the comparison app was similar to effects seen in successful drug trials, providing very compelling evidence that using this app will help people quit smoking.”
Dr. Tim McAfee, MD, MPH - Former Director, Office on Smoking and Health, CDC
What This Means for Prospective Partners
For employers, health plans, public health organizations, and health systems evaluating an approach to nicotine addiction, the study provides long-term randomized evidence supporting a fully digital behavioral approach to smoking cessation.
It also offers a more meaningful basis for evaluating cessation solutions than engagement alone or quit rates reported only among people who remain active in a program. The trial measured outcomes at 3, 6, and 12 months and retained 87.2% of participants through the final follow-up.
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Quit rates can look very different depending on how they are calculated.
Some programs report short-term results, outcomes only among participants who respond to follow-up, or quit attempts rather than sustained abstinence. Others evaluate all enrolled participants over longer periods and use clearly defined abstinence measures.
When comparing solutions, buyers should consider the length of follow-up, the definition of quitting, the percentage of participants retained, whether results come from a randomized comparison, and whether the study evaluated the same version or underlying approach used in the current product.
Long-term randomized trials offer one of the strongest methods for evaluating whether an intervention improves cessation outcomes.
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The iCanQuit trial was intentionally designed to include a diverse national sample. Secondary analyses have examined outcomes, engagement, satisfaction, and behavioral mechanisms among populations including Black adults, Hispanic and Latinx adults, rural adults, American Indian and Alaska Native adults, sexual and gender minority adults, and adults with mental health conditions.
The results are not identical in every subgroup, and they should not be reduced to a blanket statement that the intervention performed equally well for everyone. Together, however, these studies offer a more detailed view of how an ACT-based digital cessation intervention may be experienced by different populations and where additional research or adaptation may be needed.
The parent trial has also generated peer-reviewed analyses examining intervention mechanisms, app engagement, medication and e-cigarette use, environmental factors, dissemination, and cultural adaptation.
Chronic Pain Research
2Morrow was awarded a $1.9 million NIH Small Business Innovation Research grant through the NIH HEAL Initiative to develop and study a digital behavioral health program for adults living with chronic pain, in collaboration with researchers from the University of Washington School of Medicine. The program applies ACT principles to help people pursue what matters to them even in the presence of pain, rather than organizing life around avoiding it.
A 2026 feasibility study published in JMIR Human Factors examined engagement with and perceived usefulness of the Salty for Chronic Pain program.
Chronic Pain Feasibility Study at a Glance
25.5 lessons
Average number of core lessons completed.
No auto reminders
A technical issue prevented push notifications during the study.
49 / 40
Participants assigned to the app / participants who activated it.
86.7%
Of 30 survey respondents said the program helped them understand or manage their pain.
27.3 days
Average number of unique days participants used the program.
90%
Of 30 survey respondents said they would recommend the program to others.
Core lessons, daily check-ins, and content addressing the physical, emotional, and social aspects of pain were rated as helpful by most survey respondents.
This feasibility study evaluated engagement, usability, and perceived usefulness. It was not designed to establish clinical efficacy.
Publications and Research Collaborations
Research related to programs and approaches used by 2Morrow has appeared in peer-reviewed journals including JAMA Internal Medicine, Addiction, Drug and Alcohol Dependence, JMIR Public Health and Surveillance, and JMIR Human Factors.
Research and program development have included collaborations with Fred Hutchinson Cancer Center, the University of Washington School of Medicine and UW Medicine, Seattle Children’s, the University of New Mexico, Madigan Army Medical Center and Joint Base Lewis-McChord, the Washington State Department of Health, and Trinity College Dublin.
Research Governance & Transparency
Financial Conflict of Interest Policy
2Morrow’s Financial Conflict of Interest (FCOI) Policy describes legal obligations applicable to Investigators’ disclosure of potential financial conflicts of interest. The purpose of the policy is to comply with applicable law and help ensure the objectivity of research conducted by 2Morrow, its employees, contractors, and consultants.
Evidence Should Help You Make a Better Decision
Research is most useful when it helps organizations understand not only whether a program can work, but for whom, under what conditions, and how confidently the results can be applied to their population.
Our team can help you understand the evidence behind 2Morrow’s programs, how it relates to your goals, and what meaningful outcomes may look like in your setting.