Lindsey S. Sparrock

Background: Cancer remains a leading cause of morbidity worldwide. To reduce this burden, scalable, effective approaches are needed to address modifiable risk factors for cancer and support behavioral self-management. With smartphone ownership now nearly ubiquitous, mobile health (mHealth) interventions offer a powerful means to extend the reach, accessibility, and sustainability of evidence-based treatments for a variety of modifiable risk factors (eg, excessive alcohol use, physical inactivity, poor diet, and smoking). Moreover, the flexibility of mHealth platforms enables efficient delivery of novel interventions, supports innovative study designs, and facilitates real-time data collection to advance public health research. Objective: Despite the great potential of mHealth interventions, developing high-quality mHealth tools is complex, time-consuming, and resource-intensive. To address these challenges, we are developing a coordinated, accessible, research-grade infrastructure for mHealth app development, testing, and dissemination. Methods: The mHealth Florida infrastructure (mFLi) will provide a comprehensive, low-code software platform that enables researchers to build apps compatible with major mobile operating systems, namely, Apple iOS and Google Android. Through a modular interface, users will select from a menu of prebuilt features to tailor functionality to specific study needs. The platform will include 3 integrated environments (development, testing, and production), allowing researchers to prototype, evaluate, and deploy mHealth interventions. This infrastructure will be developed and maintained by a multidisciplinary team, ensuring that the platform is technically robust and usable and adheres to institutional and regulatory standards. To demonstrate the platform’s functionality, utility, and adaptability, a multisite study comprising three initial projects focused on smoking cessation among patients with cancer is being conducted: (1) participant screening and enrollment, (2) randomization and treatment delivery, and (3) data processing using machine learning methods with on-device and cloud-based approaches. Results: This study was funded in May 2023, and ethics approval was obtained from all involved sites’ institutional review boards between February 2024 and October 2025. Recruitment began in March 2025 and enrollment is ongoing. As of January 2026, 41% (37/90) of the target sample have been enrolled and 21% (19/90) have completed their 6-month assessment. Data collection will be completed once the final participant completes their 6-month assessment (expected May 2027), with analyses commencing thereafter. Study findings are anticipated to be published in a peer-reviewed journal in 2027. Conclusions: Collectively, these projects will illustrate how mFLi can streamline app development, facilitate rapid translation of research into practice, and reduce barriers for researchers and developers. Ultimately, mFLi is designed to accelerate innovation in mHealth research, enhance access to behavioral interventions, and improve health outcomes among diverse populations. Trial Registration: ClinicalTrials.gov NCT06909357; https://clinicaltrials.gov/study/NCT06909357 International Registered Report Identifier (IRRID): PRR1-10.2196/92288

BACKGROUND Cancer remains a leading cause of morbidity worldwide. To reduce this burden, scalable, effective approaches are needed to address modifiable risk factors for cancer and support behavioral self-management. With smartphone ownership now nearly ubiquitous, mobile health (mHealth) interventions offer a powerful means to extend the reach, accessibility, and sustainability of evidence-based treatments for a variety of modifiable risk factors (eg, excessive alcohol use, physical inactivity, poor diet, and smoking). Moreover, the flexibility of mHealth platforms enables efficient delivery of novel interventions, supports innovative study designs, and facilitates real-time data collection to advance public health research. OBJECTIVE Despite the great potential of mHealth interventions, developing high-quality mHealth tools is complex, time-consuming, and resource-intensive. To address these challenges, we are developing a coordinated, accessible, research-grade infrastructure for mHealth app development, testing, and dissemination. METHODS The mHealth Florida infrastructure (mFLi) will provide a comprehensive, low-code software platform that enables researchers to build apps compatible with major mobile operating systems, namely, Apple iOS and Google Android. Through a modular interface, users will select from a menu of prebuilt features to tailor functionality to specific study needs. The platform will include 3 integrated environments (development, testing, and production), allowing researchers to prototype, evaluate, and deploy mHealth interventions. This infrastructure will be developed and maintained by a multidisciplinary team, ensuring that the platform is technically robust and usable and adheres to institutional and regulatory standards. To demonstrate the platform’s functionality, utility, and adaptability, a multisite study comprising three initial projects focused on smoking cessation among patients with cancer is being conducted: (1) participant screening and enrollment, (2) randomization and treatment delivery, and (3) data processing using machine learning methods with on-device and cloud-based approaches. RESULTS This study was funded in May 2023, and ethics approval was obtained from all involved sites’ institutional review boards between February 2024 and October 2025. Recruitment began in March 2025 and enrollment is ongoing. As of January 2026, 41% (37/90) of the target sample have been enrolled and 21% (19/90) have completed their 6-month assessment. Data collection will be completed once the final participant completes their 6-month assessment (expected May 2027), with analyses commencing thereafter. Study findings are anticipated to be published in a peer-reviewed journal in 2027. CONCLUSIONS Collectively, these projects will illustrate how mFLi can streamline app development, facilitate rapid translation of research into practice, and reduce barriers for researchers and developers. Ultimately, mFLi is designed to accelerate innovation in mHealth research, enhance access to behavioral interventions, and improve health outcomes among diverse populations. CLINICALTRIAL ClinicalTrials.gov NCT06909357; https://clinicaltrials.gov/study/NCT06909357 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/92288

Introduction: Cigarette taste is a central component of the rewarding effects of smoking. It has been suggested that foods and beverages may alter the taste of cigarettes. However, little is known about the relationship between foods and cigarette taste. Methods: The present investigation assessed smokers' perceptions of how different foods and beverages affect cigarette taste using a newly developed 23-item questionnaire administered as part of a parent study that recruited a balanced sample of Black and White and menthol and non-menthol smokers (N = 100). Results: Some foods and beverages were perceived as enhancing (e.g., alcohol, coffee, beef) or worsening (e.g., milk/dairy, vegetables, fruits) the reported taste of cigarettes regardless of race and menthol smoking status. For some foods and beverages there were differences in ratings based on menthol status or race, but no interactions. There were also differences in some food consumption frequencies based on race and/or menthol status. Conclusions: Foods may differentially affect cigarette taste, which could affect both smoking and dietary choices. Future research should examine the relationship between food and smoking taste and reward with larger and more diverse samples as any effects of foods on cigarette taste could have important public health implications.

Little is known about awareness, beliefs, and use of nicotine pouches (NPs). Data from 1583 U.S. adult (age ≥ 21 years) current tobacco users were collected in 2021. Respondents self-reported NP awareness, beliefs, use, and susceptibility as well as current tobacco product use and socio-demographics. We used weighted logistic and multinomial regression models to explore the associations between these variables. Overall, 46.6% of U.S. adult current tobacco users were aware of, 16.4% had ever used, and 3.0% currently used NPs. Younger individuals (vs. 61+ years) were more likely to have ever heard of NPs, while Black individuals (vs. White) were less likely to have ever heard of NPs. Individuals younger than 45 years (vs. 61+ years) and those using smokeless tobacco products (vs. non-users) were more likely to have ever used NPs. Additionally, younger than 45 years (vs. 61+ years) and current use of certain tobacco products (e.g., smokeless) were associated with current NP use. Holding favorable beliefs about NPs was associated with susceptibility to and more advanced NP use statuses (p < 0.05). Continuous surveillance of NP use and beliefs is important.

Limited data exist on the awareness, beliefs, and use of heated tobacco products (HTPs). Data from 1583 U.S. adult (age ≥ 21 years) current tobacco users were collected in 2021. Participants self-reported HTP awareness, beliefs, use, and susceptibility, as well as current tobacco product use and sociodemographics. We used weighted logistic and multinomial regression models to explore their associations. Overall, 23.6% were aware of, 8.9% had ever used, and 3.0% currently used HTPs. Younger individuals (vs. 61+ years), those with annual income $50,000+ (vs. <$50,000), and those currently using electronic vaping products (vs. non-users) were more likely to be aware of, to have ever used, and to currently be using HTPs (p < 0.05). Black individuals (vs. White) were more likely to report ever and current HTP use (p < 0.05). Current cigarette smoking was not associated with HTP awareness and use (p > 0.05). Holding favorable HTP beliefs was associated with susceptibility to and more advanced HTP use statuses (p < 0.05). Sociodemographics associated with HTP use may reflect HTP marketing strategies. The lack of association with cigarette smoking suggests HTPs may be unlikely cigarette substitutes. Addressing favorable HTP-related beliefs may prevent dual use.