. 2022 Jul 29;14(3):229–238. doi: 10.34172/ahj.2022.1225

Table 2. Published and forthcoming papers on ACT for smoking cessation .

First Author Publication Year Country	Target variables	Treatment arm (n); Delivery period	Population	Results
Heffner et al²⁴ 2021 USA	Abstinence	Avatar-led digital Acceptance and Commitment therapy (n = 22) (EQQUAL program) Delivery period: 6 weeks	Sexual and gender minority young adult smokers	Treatment was accepted easier in the intervention group. The level of abstinence (which was biochemically confirmed) in the intervention group was three times higher than in the control group in sexual and gender minority young adult smokers.
Mak et al¹⁷ 2021 Hong Kong	Quit rates Experiential avoidance	Acceptance and Commitment Therapy (n = 65) Social Support (n = 65) Delivery period: 10 weeks	Smokers with schizophrenia	The results showed that the quit rates in the ACT group were higher than in the social support group. However, this difference was not significant (six months follow-up: 12.3% vs. 7.7%, P > 0.05, one-year: 10.8% vs. 7.7%, P > 0.05). Moreover, this study found significantly greater improvements in experiential avoidance and less reliance on emotion regulation strategies in the ACT group.
Mak et al²⁵ 2020 China	Abstinence	Acceptance and Commitment Therapy + self-help materials on smoking cessation (n = 70) Self-help materials on smoking cessation as the control group (n = 74)	The general population of smokers	At the 12-month follow-up, there was no significant difference in the prevalence of 7-day self-reported quit rates between the intervention group (24.3%) and the control group (21.6%). Participants in ACT were more motivated to complete treatment than control group. In addition, this group showed higher values of psychological flexibility than control group.
O'Connor M²⁶ 2020 USA	Cessation Nicotine dependence Positive mental health	Behavioral support group (n = 50) ACT group (n = 50) ACT together with an application for cessation (n = 50) Delivery period: 6 weeks	The general population of smokers	After a 6-month follow-up, there was no significant difference in smoking cessation rate between the three groups. However, after post-test, the group with the compound program had a higher cessation rate than the group with the behavioral support program. It is essential to mention that there were no significant differences between the three groups in positive mental health.
Heffner JL¹⁴ 2020 USA	Mental health symptoms	Web-delivered Acceptance and Commitment Therapy (WebQuit Plus, n = 25) Smokefree.gov (n = 26)	Treatment-seeking adult smokers with bipolar disorder	During post-test, the WebQuit Plus group had a higher cessation rate than the Smokefree.gov group. Nevertheless, no significant difference was detected in the follow-up assessment. However, the WebQuit Plus group had a higher tendency to continue the intervention.
Karekla²³ 2019 Cyprus	Smoking cessation	Avatar-led based Acceptance and Commitment Therapy (n = 49, 64.3% = females) Delivery period: 6 weeks	Young college students	The group that completed the therapy had a higher cessation rate than the group that did not complete all therapy sessions. Moreover, the patients who had partly participated in the program had a reduction in smoking. The participants under study described the program as acceptable and satisfying.
Watson NL²¹ 2019 USA	Cessation Symptoms of Depression and Anxiety Disorders	Web-based ACT U.S. standard web-based smoking interventions	Smokers with and without affective disorders	Compared to the group without anxiety disorders, all six subgroups with anxiety disorders showed significantly higher satisfaction with their assigned Web treatment program but had shorter enrollment times than the group without anxiety disorders.
McClure JB¹³ 2018 USA	Abstinence Acceptance of Cravings	ACT (n = 224) CBT (n = 226) Delivery period: 8 weeks	Adult smokers in Washington State	After a one-year follow-up, there was no significant inter-group difference in abstinence and cravings.
Vilardaga²⁰ 2019 USA	Positive and Negative Syndrome Smoking behavior	The patients received both the Learn to Quit (LTQ) and NCI QuitGuide (QG) programs. The program was randomly assigned to the individuals (n = 7). Delivery period: 30 days	Smokers with serious mental illness	The LTQ was more helpful than NCI, but NCI was more popular. In addition, participating in the LTQ program reduced all participants’ positive and negative syndrome scale scores. LTQ is a safe and valuable program for improving cessation skills in patients with severe psychiatric problems.
Bricker JB²⁷ 2018 USA	Cessation	WebQuit Online Smoking Cessation program (intervention group) (N = 1318) Smokefree.gov online website (Control) n = 1319))	Treatment-seeking adult smokers	Both treatments had the same one-month abstinence after one year.
Singh S¹⁸ 2017 New Zealand	Cessation Craving	The innovative Suit® application with ACT-based content was given to people as time series. (N = 10). Quit date varied from at least two weeks to six months	Treatment-seeking adult smokers	Even though craving had no significant change during different phases, smoking reduced significantly; 3 of the participants did not smoke at all for more than one year.
Davoudi M⁶ 2017 IRAN	Cessation Depression Anxiety	ACT (n = 35) CBT (n = 35) Delivery period: 8 weeks	Treatment-seeking adult smokers	Compared to the CBT group, the ACT group had significant improvements in depression and anxiety. Moreover, ACT led to a significant improvement in smoking cessation.
Bricker JB²⁸ 2017 USA	Smoking cessation Smoking reduction	Acceptance and commitment therapy smartphone application (n = 99) Delivery period: 30 days	Treatment-seeking adult smokers	In this study, a new version of an ACT-based application was compared to the research results of another study by the same researchers on the same population. It was concluded that compared to the previous application, the new version led to a considerable growth in the abstinence rate. Moreover, it significantly decreased the smoking rate in other populations.
Heffner JL¹⁵ 2015 USA	Smoking cessation	ACT in-person (n = 10) Telephone-based ACT (n = 6) Delivery period:10 weeks	Treatment-seeking adult smokers with bipolar disorder	In this study, there was no comparison to highlight any significant differences. On the whole, the group which received individual therapy in-person had a cessation rate of seven days or more. However, during the 30-day-follow-up period, the cessation rate was the same for both groups. During the therapy, the group that participated in the sessions in person had more days of abstinence and were more receptive and enthusiastic.
Jones HA¹⁶ 2015 USA	Cessation Anxiety and depression	WebQuit. web-based treatment (ACT) (n = 47) Smokefree.gov web-based treatment Control) (n = 47) Delivery period:30 days	Smokers with depressive symptoms	On the whole, there was no significant difference between groups in the 30-day cessation rate or depressive symptom reduction. However, in the ACT group, the descriptive data indicated a higher cessation rate and a more significant improvement in depressive symptoms. Furthermore, the patients who used the WebQuit reported higher levels of satisfaction about program than control group.
Kelly MM¹² 2015 USA	PTSD symptoms Smoking cessation	ACT (n = 19) Delivery period:10 weeks	Smoking Veterans with PTSD	In this one-group study, compared to baseline, the percentage of quitting was 37% after the end of the therapy and 16% after the 3-month follow-up. Moreover, PTSD symptoms were significantly fewer in comparison with the baseline.
Bricker JB¹⁹ 2014 USA	Quit rates Depressive symptoms Cravings	Telephone-based ACT + NRT (n = 60) Telephone-based CBT + NRT(n = 60)	South Carolina State adult smokers	The ACT group continued treatment for a longer period than participants in CBT. In the ACT group, for both depressive and non-depressive patients, the 30-day and 6-month cessation rates were significantly higher. ACT leads to resisting cravings in smokers more significantly.
Bricker JB²⁹ 2014 USA	Cessation Craving	Mobile-based acceptance and commitment therapy (n = 80) (National Cancer Institute's application for smoking cessation (QuitGuide) (n = 84)) Delivery period: 8 weeks	Treatment-seeking adult smokers	While QuitGuide participants used their application 15.2 times on average, SmartQuit participants used their application for an average of 37.2 times. The total smoking rates for SmartQuit and QuitGuide were 13% and 8% percent, respectively (OR = 2.7; 95% Cl = 0.8–10.3). In line with the theory of change in ACT, for the ones who had low scores (under the median) on Acceptance of cravings experiences during baseline (n = 88), the quit rates were 15% and 8% in SmartQuit and QuitGuide, respectively (OR = 2.9; 95% Cl = 0.6– 20.7).
Bricker J²² 2013 USA	Cessation	Web-based ACT (WebQuit) (n = 111) Smokefree.gov-the U.S. standard web-based smoking interventions (n = 111)	Treatment-seeking adult smokers	Compared with the control group (Smokefree.gov), the intervention group (ACT) showed higher user receptivity and short-term cessation, and promising evidence of ACT-based mechanisms of change.
Bricker JB³⁰ 2010 USA	Quit rates	Telephone-based ACT (n = 14) Delivery period: 5 sessions	Adult smokers	According to the results of this study, the cessation rate was 29% seven days after the end of the intervention, and the same rate continued until the 12-month follow-up.