Innovations in the Interception of Lung Cancer: How a Smartphone App May Aid Smoking Cessation in China
Many risk factors of lung cancer are known, and its pre-malignant state continues to emerge through insights in genetic markers, disease heterogeneity and pathogenesis.1 Still, lung cancer is the leading cause of cancer death worldwide, claiming the lives of about 1.8 million people per year.2
The World Without Disease Accelerator (WWDA), a group within the Janssen Pharmaceutical Companies of Johnson & Johnson, and the Lung Cancer Initiative (LCI) at Johnson & Johnson* have a bold vision: prevent, intercept and cure diseases, such as lung cancer. The groups are taking a multidisciplinary approach towards creating a world where people may be able to live healthier lives through both technological and medical advances.
As we recognize Lung Cancer Awareness Month this November, Congyang (Tom) Wu, Asia Pacific Head, WWDA, and Kevin Wildenhaus, Ph.D., Behavioral Science Lead, WWDA, shared an update on an exciting project: a digital smoking cessation smartphone app that leverages the latest behavioral science research with an aim to potentially prevent lung cancer in China.
First, why focus on lung cancer in China?
Tom: China has become the epicenter for the lung cancer epidemic worldwide. About 27 percent of the Chinese population – and more than half of all men in China – are smokers.3 There were more than one million deaths in China associated with smoking in 2010, and this number is expected to double by 2030.4
Kevin: Despite this high unmet need, we quickly came to two critical realizations when we started digging into this opportunity: 1) Awareness of the dangers of smoking was quite low among people in China, and 2) Unlike many countries, there are very few effective digital smoking cessation apps or innovations available to the Chinese population.
How does the investigational digital smoking cessation app work and how it is being tested?
Kevin: Our smartphone app was designed for use with Chinese smokers. Our solution is based on a cognitive behavioral therapy (CBT) approach to help users recognize and understand the mental and emotional aspects that contribute to why they smoke, including mood, memory, habits, and triggers. Using CBT enables digital patient engagement, designed to help people learn from their own data to reconsider their smoking tendencies, with the goal of guiding them to quit smoking in hopes of lowering their risk of developing lung cancer.
Tom: To implement this app, we are collaborating with key opinion leaders on addiction and smoking cessation from academic institutions, and top IT solution providers in China. We have also conducted other assessments to refine and modify the program and carried out a home-use test of the app with smokers in Shanghai and Changsha, and we look forward to sharing the results of this study with the public soon. Next, we’re looking to launch a robust clinical study with participants who are smokers to validate the design and efficacy of the app.
How could this smoking cessation app support the mission of the WWDA and LCI, which aim to prevent, intercept and cure lung cancer?
Tom: One of the core principles of the LCI is a focus on disease prevention innovations. My team and I believe the best cure for any disease is to not get it in the first place. That’s why this smartphone app fits the WWDA and LCI mission perfectly. Our ultimate goal, albeit bold, is to increase smoking cessation in China and hopefully prevent and intercept lung cancer by helping smokers quit.
Kevin: Our vision is to create a world without lung cancer, so we need to focus on smoking cessation efforts globally. We believe that these initial efforts in China may help to address the largest market for smokers in the world today, therefore having the potential for an enormous population health impact. In addition, the lessons learned from these studies can help us develop smoking cessation interventions that can be adapted and translated to other countries, geographies, and populations around the world.
Why is this smoking cessation research important to you personally, and to those at risk of developing lung cancer?
Kevin: As fate sometimes happens, shortly after I started working with the team on this smoking cessation initiative, a close family member was diagnosed with lung cancer, making the call to intercept the disease that much more urgent and personal. Fortunately, they were diagnosed and treated very early, and have been in remission since then. Lung cancer can be a curable disease – if we diagnose it early enough, and certainly if we prevent it from occurring in the first place. Ongoing awareness of the dangers of smoking and the signs and risks of lung cancer are one key component to tackling and defeating this disease.
Tom: I, too, have a very close relative, a suspected victim of secondhand smoke, who was unfortunately diagnosed with lung cancer at a late stage. Going through such a painful experience with my family and seeing the suffering that lung cancer patients face has helped fuel my dedication to my work in smoking cessation. This is one of the most meaningful and exciting projects I have been a part of since joining J&J, as we have the opportunity to use personalized, digital medicine to potentially help millions of people in China – and worldwide – in the future.
* The legal entity of the Lung Cancer Initiative at Johnson & Johnson is Johnson & Johnson Enterprise Innovation Inc.
November 1, 2021
1 Cancer Fact Sheet. World Health Organization. October 2021. Available at http://www.who.int/mediacentre/factsheets/fs297/en/
2 Sung, H, Ferlay, J, Siegel, RL, Laversanne, M, Soerjomataram, I, Jemal, A, Bray, F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021:71:209-249. https://doi.org/10.3322/caac.21660
3 Parascandola M, Xiao L. Tobacco and the lung cancer epidemic in China. Transl Lung Cancer Res. 2019;8(Suppl 1):S21-S30. doi:10.21037/tlcr.2019.03.12
4 Chen Z, Peto R, Zhou M, et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet 2015;386:1447-56. 10.1016/S0140-6736(15)00340-2