Research Publications
Peer-reviewed research connected to 2Morrow programs, iCanQuit and SmartQuit, and 2Morrow’s chronic pain research.
Research connected to 2Morrow includes randomized clinical trials, secondary analyses, observational research, qualitative studies, feasibility research, dissemination studies, and cultural adaptation work. Study designs and levels of evidence vary and are labeled below so readers can understand what each publication contributes.
Last reviewed: August 2026
What is iCanQuit?
iCanQuit was the app used in the Phase III randomized controlled trial (n=2,415) conducted by Fred Hutchinson Cancer Center; an earlier version was called SmartQuit. 2Morrow first partnered with Fred Hutch in 2012 to build and study a mobile app version of their ACT-based smoking cessation program. Over the years, Fred Hutch has continued its research, while 2Morrow built a real-world version based on the same approach, now delivered as part of 2Morrow Health.
The iCanQuit name remains trademarked by the original researcher, who uses it for ongoing research. 2Morrow owns the exclusive license for real-world use.
How to read iCanQuit evidence
The 2020 JAMA Internal Medicine article reports the results of the parent Phase III randomized clinical trial involving 2,415 adults. Many later publications are peer-reviewed secondary analyses of that same trial. They add important information about engagement, mechanisms, populations, medication use, and environmental factors, but they are not separate randomized trials.
Tobacco Cessation Research
Featured Clinical Trial
PHASE III RANDOMIZED CLINICAL TRIAL | 2020
Efficacy of Smartphone Applications for Smoking Cessation: A Randomized Clinical Trial
Bricker JB, Watson NL, Mull KE, Sullivan BM, Heffner JL. JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2020.4055.
The parent iCanQuit trial enrolled 2,415 adults from all 50 states and compared the ACT-based iCanQuit app with the National Cancer Institute’s QuitGuide app over 12 months. This is the primary clinical efficacy publication for the iCanQuit research program.
Research Across Populations
The publications below are secondary analyses of the parent iCanQuit trial. Results vary by population and should be interpreted within each study’s sample size and design.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among American Indians and Alaska Natives: Results From the iCanQuit Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. Nicotine & Tobacco Research. DOI: 10.1093/ntr/ntab213.
This exploratory subgroup analysis examined cessation outcomes, engagement, satisfaction, and ACT-related processes among American Indian and Alaska Native participants.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Efficacy and Utilization of an Acceptance and Commitment Therapy-Based Smartphone Application for Smoking Cessation Among Black Adults: Secondary Analysis of the iCanQuit Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. Addiction. DOI: 10.1111/add.15721.
This analysis examined 12-month cessation outcomes, engagement, and ACT-related processes among Black adults in the parent trial.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Efficacy and Utilization of Smartphone Applications for Smoking Cessation Among Low-Income Adults: Secondary Analysis of the iCanQuit Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2021.109258.
This study evaluated smoking cessation, engagement, and ACT-related processes among participants with lower household incomes.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Efficacy of an Acceptance and Commitment Therapy-Based Smartphone Application for Helping Rural Populations Quit Smoking: Results From the iCanQuit Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, Ferketich AK, Bricker JB. Preventive Medicine. DOI: 10.1016/j.ypmed.2022.107008.
This analysis examined cessation outcomes, engagement, satisfaction, and ACT-related processes among rural participants. The 12-month difference was not statistically significant, although short-term outcomes and engagement favored iCanQuit.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Efficacy of Smartphone Applications for Smoking Cessation in Heavy-Drinking Adults: Secondary Analysis of the iCanQuit Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. Addictive Behaviors. DOI: 10.1016/j.addbeh.2022.107377.
This study examined smoking cessation, engagement, and alcohol-related outcomes among trial participants who reported heavy drinking.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2022
Can a Smartphone Application Help Hispanic/Latinx Adults Quit Smoking? A Randomized Trial Secondary Analysis
Santiago-Torres M, Mull KE, Sullivan BM, Zvolensky MJ, Bricker JB. Journal of Contextual Behavioral Science. DOI: 10.1016/j.jcbs.2022.11.001.
This exploratory analysis examined cessation, engagement, satisfaction, and ACT-related processes among Hispanic and Latinx adults in the parent trial.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2023
Acceptance and Commitment Therapy-Based Smartphone Applications for Cessation of Tobacco Use Among Adults With High Nicotine Dependence: Results From the iCanQuit Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, Rigotti NA, Bricker JB. Substance Use & Misuse. DOI: 10.1080/10826084.2022.2161317.
This analysis examined cessation of nicotine-containing tobacco products, engagement, satisfaction, and ACT-related processes among highly nicotine-dependent adults.
POPULATION-SPECIFIC SECONDARY ANALYSIS | 2024
Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals With Mental Health Disorders Quit Smoking?
Santiago-Torres M, Mull KE, Sullivan BM, Prochaska JJ, Zvolensky MJ, Bricker JB. Depression and Anxiety. DOI: 10.1155/2024/1055801.
This analysis examined cessation, engagement, satisfaction, and ACT-related mechanisms among adults who reported or screened positive for selected mental health conditions.
EXPLORATORY POPULATION-SPECIFIC ANALYSIS | 2024
Relative Efficacy of an Acceptance and Commitment Therapy-Based Smartphone App With a Standard US Clinical Practice Guidelines-Based App for Smoking Cessation in Dual Users of Combustible and Electronic Cigarettes: Secondary Findings From a Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, Bricker JB. Substance Use & Misuse. DOI: 10.1080/10826084.2023.2293732.
This exploratory analysis examined cigarette cessation among participants who used both combustible cigarettes and e-cigarettes. Quit rates did not significantly differ between study arms in this subgroup.
EXPLORATORY POPULATION-SPECIFIC ANALYSIS | 2025
Do Smartphone Apps Impact Long-Term Smoking Cessation for Sexual and Gender Minority Adults? Exploratory Results From a 2-Arm Randomized Trial Comparing Acceptance and Commitment Therapy With Standard US Clinical Practice Guidelines
Santiago-Torres M, Mull KE, Sullivan BM, et al. Journal of Homosexuality. DOI: 10.1080/00918369.2024.2309491.
This exploratory analysis examined cessation, engagement, satisfaction, and ACT-related processes among sexual and gender minority adults. Quit rates did not significantly differ between study arms, while engagement and satisfaction were higher with iCanQuit.
THEORY-BASED SECONDARY ANALYSIS | 2026
Intersectionality in Cigarette Smoking Cessation: A Latent Class Analysis to Predict 12-Month Cessation in a Randomized Controlled Trial
Santiago-Torres M, Mull KE, Shi D, et al. Addiction. DOI: 10.1111/add.70185.
This analysis used the full parent-trial sample to examine how intersecting social identities, socioeconomic conditions, and depression symptoms were associated with 12-month cessation.
Mechanisms, Engagement & App Use
SECONDARY ANALYSIS | 2021
Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial
Bricker JB, Levin M, Lappalainen R, Mull K, Sullivan B, Santiago-Torres M. JMIR mHealth and uHealth. DOI: 10.2196/32847.
This analysis examined how app engagement and ACT-related processes were associated with the intervention’s effect on smoking cessation.
SECONDARY ENGAGEMENT ANALYSIS | 2022
Smoking Cessation Smartphone App Use Over Time: Predicting 12-Month Cessation Outcomes in a 2-Arm Randomized Trial
Bricker JB, Mull KE, Santiago-Torres M, Miao Z, Perski O, Di C. Journal of Medical Internet Research. DOI: 10.2196/39208.
This study identified distinct patterns of app use over time and examined how those patterns were associated with 12-month smoking cessation outcomes.
SECONDARY PREDICTIVE ANALYSIS | 2023
Can a Single Variable Predict Early Dropout From Digital Health Interventions? Comparison of Predictive Models From Two Large Randomized Trials
Bricker J, Miao Z, Mull K, Santiago-Torres M, Vock DM. Journal of Medical Internet Research. DOI: 10.2196/43629.
Using data from iCanQuit and other digital interventions, this study examined whether first-week log-in activity could identify people at risk of early disengagement.
Treatment, Context & Related Behaviors
SECONDARY ANALYSIS | 2023
Use of e-Cigarettes in Cigarette Smoking Cessation: Secondary Analysis of a Randomized Controlled Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. JMIR mHealth and uHealth. DOI: 10.2196/48896.
This analysis examined self-selected e-cigarette use during app-based cessation treatment and its association with 12-month cigarette abstinence.
SECONDARY ANALYSIS | 2024
Do Medications Increase the Efficacy of Digital Interventions for Smoking Cessation? Secondary Results From the iCanQuit Randomized Trial
Bricker JB, Santiago-Torres M, Mull KE, Sullivan BM, et al. Addiction. DOI: 10.1111/add.16396.
This study examined whether participants’ self-selected use of FDA-approved cessation medications, including nicotine replacement therapy, was associated with stronger cessation outcomes alongside the apps.
SECONDARY ANALYSIS | 2025
Evaluating the Impact of Pharmacotherapy in Augmenting Quit Rates Among Hispanic Adults in an App-Delivered Smoking Cessation Intervention: Secondary Analysis of a Randomized Controlled Trial
Santiago-Torres M, Mull KE, Sullivan BM, et al. JMIR Formative Research. DOI: 10.2196/69311.
This analysis examined the relationship between self-selected pharmacotherapy use and cessation outcomes among Hispanic participants in the parent trial.
ENVIRONMENTAL SECONDARY ANALYSIS | 2025
Does Living Near a Tobacco Retailer Impact the Efficacy of Smoking Cessation Treatments? Analysis From a Randomized Trial
Santiago-Torres M, Mull KE, Sullivan BM, Bricker JB. Addictive Behaviors Reports. DOI: 10.1016/j.abrep.2025.100635.
This study examined whether neighborhood tobacco-retailer density was associated with treatment outcomes in the parent iCanQuit trial.
Dissemination & Cultural Adaptation
QUASI-EXPERIMENTAL DISSEMINATION STUDY | 2025
Population-Level Dissemination of a Smoking Cessation Smartphone App: Quasi-Experimental Comparison of Values-Based Messages in Social Media Advertisements
Bricker JB, Santiago-Torres M, Mull KE, Sullivan BM, Mehrotra R. JMIR mHealth and uHealth. DOI: 10.2196/71619.
This study compared values-based social media messages used to disseminate iCanQuit among adults in seven major cities in India, focusing on reach, installs, app use, and cost.
CULTURAL ADAPTATION STUDY | 2026
Development of a Culturally Adapted Smartphone App (IndigeQuit) Designed to Help American Indian and Alaska Native People Quit Commercial Cigarettes: User-Centered Mixed Methods Study
Bricker JB, Santiago-Torres M, Sullivan BM, et al. JMIR Formative Research. DOI: 10.2196/88768.
This study used community-based and user-centered methods to adapt iCanQuit into IndigeQuit. It evaluates the adaptation process and early user feedback, not the efficacy of the original or adapted app.
Foundational SmartQuit Research
SmartQuit was an earlier version of the ACT-based smoking cessation app that preceded iCanQuit.
RANDOMIZED PILOT TRIAL | 2014
Randomized, Controlled Pilot Trial of a Smartphone App for Smoking Cessation Using Acceptance and Commitment Therapy
Bricker JB, Mull KE, Kientz JA, Vilardaga R, Mercer LD, Akioka KJ, Heffner JL. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2014.07.006.
This early randomized pilot compared SmartQuit with QuitGuide and examined feasibility, engagement, preliminary cessation outcomes, and ACT-related processes.
SINGLE-ARM PILOT TRIAL | 2017
Single-Arm Trial of the Second Version of an Acceptance & Commitment Therapy Smartphone Application for Smoking Cessation
Bricker JB, Copeland W, Mull KE, Zeng EY, Watson NL, Akioka KJ, Heffner JL. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2016.10.029.
This pilot evaluated participant receptivity, short-term cessation and reduction, and program completion for SmartQuit 2.0.
SINGLE-SUBJECT STUDY | 2017
Using SmartQuit®, an Acceptance and Commitment Therapy Smartphone Application, to Reduce Smoking Intake
Singh S, Starkey NJ, Sargisson RJ. DIGITAL HEALTH. DOI: 10.1177/2055207617729535.
This small New Zealand study used a single-subject design to examine cigarette use and cravings before, during, and after access to SmartQuit. It provides additional early feasibility evidence but should not be presented as equivalent to a randomized clinical trial.
2Morrow Real-World Tobacco Research
REAL-WORLD OBSERVATIONAL STUDY | 2022
Analysis of Demographic Characteristics of Users of a Free Tobacco Cessation Smartphone App: Observational Study
Fradkin N, Zbikowski SM, Christensen T. JMIR Public Health and Surveillance. DOI: 10.2196/32499.
This study examined who activated the 2Morrow Health Smoking & Tobacco app through a Washington State public health program and how users compared with the state’s adult tobacco-user population. It describes reach and participant characteristics, not cessation efficacy.
Chronic Pain Research
QUALITATIVE HUMAN-CENTERED DESIGN STUDY | 2023
Developing Digital Therapeutics for Chronic Pain in Primary Care: A Qualitative Human-Centered Design Study of Providers’ Motivations and Challenges
Ma KPK, Stephens KA, Geyer RE, Prado MG, Mollis BL, Zbikowski SM, Waters D, Masterson J, Zhang Y. JMIR Formative Research. DOI: 10.2196/41788.
This study explored primary care providers’ strategies, challenges, and needs in chronic pain management to inform the design and implementation of a digital chronic pain program.
FEASIBILITY TRIAL SECONDARY ANALYSIS | 2026
Participant Engagement With a Digital Behavioral Health App for Chronic Pain: Descriptive Secondary Analysis of a Feasibility Randomized Controlled Trial
Zbikowski SM, Masterson J, Burrola-Mendez Y, Hsu C, Ma KPK, Zhang Y, Waters D, Stephens KA. JMIR Human Factors. DOI: 10.2196/88122.
This study examined engagement with and perceived usefulness of the Salty for Chronic Pain program among adults in primary care. It evaluated feasibility, use, usability, and satisfaction and was not designed to establish clinical efficacy.
Research Standards
This page includes publicly available research with a stable publication record. Study type and evidence level are stated so that randomized trials, secondary analyses, observational studies, feasibility research, qualitative studies, dissemination research, and adaptations are not presented as equivalent.
Looking for the Research Overview?
For a plain-language summary of the evidence, key trial findings, chronic pain research, and what the results may mean for prospective partners, visit our Research, Evidence & Insights page.