Trial Outcomes & Findings for GeoScan and Remote Geo Smoking Study: Neural and Behavioral Correlates of Smokers' Exposure to Retail Environments (NCT NCT04279483)

Last Updated: 2025-08-14

Results Overview

Participants were asked 4 times per day, for the 28 days of the intervention period, to rate their level of craving for a cigarette. They responded to the question "Right now, how much do you want to smoke a cigarette?" using a 100-point scale from 0 (not at all) to 100 (extremely). Craving ratings were first averaged within each day, for each participant; then were averaged across the intervention period days for each participant; and finally averaged across participants in each group.

Recruitment status

COMPLETED

Study phase

Target enrollment

343 participants

Primary outcome timeframe

4-week experimental manipulation period

Results posted on

2025-08-14

Participant Flow

Adults who smoked cigarettes daily were recruited across PA, DE, and NJ to complete a multi-part, remote study. Recruitment materials for this study were primarily distributed by a clinical trials recruitment company, which utilized study advertisements to engage participants on digital platforms such as Facebook, Google, and WebMD. All recruitment materials included links directing potential participants to the initial screening survey.

Participants completed several screening steps to confirm eligibility and interest in the study. If eligible, they completed the first online survey session, and then began the baseline period, during which they answered questions about their cigarette craving and smoking multiple times daily and recorded their geolocation through the Google Maps smartphone application. Participants who completed the baseline period and began the intervention period were assigned to an experimental condition.

Participant milestones

Participant milestones
Measure	Tobacco Retailer Group Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period	Unassigned Participants who enrolled in the study but did not complete the baseline period and therefore were not assigned an experimental condition
Baseline Period STARTED	109	109	76	49
Baseline Period Began Baseline Period	109	109	76	36
Baseline Period COMPLETED	109	109	76	10
Baseline Period NOT COMPLETED	0	0	0	39
Intervention Period STARTED	109	109	76	0
Intervention Period Completed All Store Visits	55	46	0	0
Intervention Period COMPLETED	88	92	74	0
Intervention Period NOT COMPLETED	21	17	2	0
fMRI Scans STARTED	10	13	13	1
fMRI Scans Completed Second Scan	1	3	5	0
fMRI Scans COMPLETED	10	12	13	0
fMRI Scans NOT COMPLETED	0	1	0	1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Tobacco Retailer Group n=109 Participants Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=109 Participants Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=76 Participants Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period	Unassigned n=49 Participants Participants who enrolled in the study, but did not complete the baseline period and were therefore not assigned to an experimental condition	Total n=343 Participants Total of all reporting groups
Age, Continuous	44 years STANDARD_DEVIATION 11 • n=109 Participants	42 years STANDARD_DEVIATION 11 • n=109 Participants	42 years STANDARD_DEVIATION 10 • n=76 Participants	43 years STANDARD_DEVIATION 11 • n=49 Participants	43 years STANDARD_DEVIATION 11 • n=343 Participants
Sex/Gender, Customized Sex/gender · Female	59 Participants n=109 Participants	60 Participants n=109 Participants	42 Participants n=76 Participants	20 Participants n=49 Participants	181 Participants n=343 Participants
Sex/Gender, Customized Sex/gender · Male	46 Participants n=109 Participants	44 Participants n=109 Participants	32 Participants n=76 Participants	25 Participants n=49 Participants	147 Participants n=343 Participants
Sex/Gender, Customized Sex/gender · Other	3 Participants n=109 Participants	5 Participants n=109 Participants	1 Participants n=76 Participants	0 Participants n=49 Participants	9 Participants n=343 Participants
Sex/Gender, Customized Sex/gender · Unknown	1 Participants n=109 Participants	0 Participants n=109 Participants	1 Participants n=76 Participants	4 Participants n=49 Participants	6 Participants n=343 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	9 Participants n=109 Participants	7 Participants n=109 Participants	3 Participants n=76 Participants	3 Participants n=49 Participants	22 Participants n=343 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	99 Participants n=109 Participants	102 Participants n=109 Participants	71 Participants n=76 Participants	42 Participants n=49 Participants	314 Participants n=343 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	1 Participants n=109 Participants	0 Participants n=109 Participants	2 Participants n=76 Participants	4 Participants n=49 Participants	7 Participants n=343 Participants
Race (NIH/OMB) American Indian or Alaska Native	1 Participants n=109 Participants	0 Participants n=109 Participants	1 Participants n=76 Participants	0 Participants n=49 Participants	2 Participants n=343 Participants
Race (NIH/OMB) Asian	0 Participants n=109 Participants	3 Participants n=109 Participants	3 Participants n=76 Participants	2 Participants n=49 Participants	8 Participants n=343 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=109 Participants	0 Participants n=109 Participants	0 Participants n=76 Participants	0 Participants n=49 Participants	0 Participants n=343 Participants
Race (NIH/OMB) Black or African American	27 Participants n=109 Participants	24 Participants n=109 Participants	17 Participants n=76 Participants	25 Participants n=49 Participants	93 Participants n=343 Participants
Race (NIH/OMB) White	75 Participants n=109 Participants	69 Participants n=109 Participants	47 Participants n=76 Participants	17 Participants n=49 Participants	208 Participants n=343 Participants
Race (NIH/OMB) More than one race	2 Participants n=109 Participants	9 Participants n=109 Participants	4 Participants n=76 Participants	0 Participants n=49 Participants	15 Participants n=343 Participants
Race (NIH/OMB) Unknown or Not Reported	4 Participants n=109 Participants	4 Participants n=109 Participants	4 Participants n=76 Participants	5 Participants n=49 Participants	17 Participants n=343 Participants
Region of Enrollment United States	109 Participants n=109 Participants	109 Participants n=109 Participants	76 Participants n=76 Participants	49 Participants n=49 Participants	343 Participants n=343 Participants
Daily cigarette craving	47.89 units on a scale STANDARD_DEVIATION 20.70 • n=109 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	49.17 units on a scale STANDARD_DEVIATION 19.61 • n=109 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	48.03 units on a scale STANDARD_DEVIATION 20.81 • n=76 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	59.86 units on a scale STANDARD_DEVIATION 19.42 • n=28 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	49.40 units on a scale STANDARD_DEVIATION 20.43 • n=322 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.
Daily cigarette count	13.29 cigarettes STANDARD_DEVIATION 6.35 • n=109 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	14.17 cigarettes STANDARD_DEVIATION 19.18 • n=109 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	14.05 cigarettes STANDARD_DEVIATION 9.84 • n=76 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	14.17 cigarettes STANDARD_DEVIATION 9.18 • n=28 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.	13.71 cigarettes STANDARD_DEVIATION 8.71 • n=322 Participants • Some participants in the Unassigned group did not respond to any daily messages and are not represented in the average.

PRIMARY outcome

Timeframe: 4-week experimental manipulation period

Population: All participants who responded to any craving rating questions during the intervention period are included in this average. Participants in the "unassigned" group did not begin the intervention period and therefore are have no outcome data to report.

Outcome measures

Outcome measures
Measure	Tobacco Retailer Group n=101 Participants Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=104 Participants Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=75 Participants Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period
Self-reported Cigarette Craving During the Experimental Manipulation Period	48.33 units on a scale Standard Deviation 25.30	49.14 units on a scale Standard Deviation 22.96	47.17 units on a scale Standard Deviation 24.24

PRIMARY outcome

Timeframe: 4-week experimental manipulation period

Population: All participants who responded to any cigarette consumption questions during the intervention period are included in this average. Participants in the "unassigned" group did not begin the intervention period and therefore are have no outcome data to report.

Participants were asked 2 times per day, for the 28 days of the intervention period, to respond to the question, "Within \[timeframe\], how many cigarettes did you smoke?". We calculated a daily sum for each individual, imputing missing counts from the average of that individual's prior reports (missing values for the first daily survey were imputed from the average of that participant's first daily survey answers; and vice versa for the second survey). We averaged the daily counts for each participant, and then averaged across participants.

Outcome measures

Outcome measures
Measure	Tobacco Retailer Group n=101 Participants Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=104 Participants Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=75 Participants Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period
Self-reported Number of Cigarettes Smoked Per Day During the Experimental Manipulation Period	12.72 cigarettes Standard Deviation 6.26	12.88 cigarettes Standard Deviation 8.27	13.64 cigarettes Standard Deviation 7.55

PRIMARY outcome

Timeframe: [Time Frame: For 822815, fMRI scan 1 (at least 2 weeks after initial enrollment); for 850796, fMRI scan 1 (at least 6 weeks after initial enrollment)]]

Population: Participants who completed at least one scan and whose data passed quality thresholds for in-scanner movement and response rate. Due to COVID-19 pandemic restrictions during data collection, we changed the protocol to make the fMRI scan optional, which means that we do not have adequate statistical power to test experimental group differences. No participants in the "unassigned" group were scanned, since they did not begin the intervention period.

In key neural cue reactivity regions (based on prior work), we extracted estimates of neural activity during exposure to standardized smoking cues (e.g., photographs of a cigarette pack) and during exposure to standardized nonsmoking cues (approximately compositionally matched, e.g., a pack of pencils). We used SPM12 to create first-level (within-subject) linear regression models to estimate BOLD (blood oxygenation level dependent) activity at each voxel across all repetitions of each task condition, within each subject; and to create contrast estimates comparing task conditions. We used nilearn tools to average task condition contrast estimates across voxels within the regions of interest for each participant. The data values below reflect this contrast estimate - the difference in neural activity as percent change in BOLD signal between the standardized smoking cues condition and the standardized nonsmoking cues condition.

Outcome measures

Outcome measures
Measure	Tobacco Retailer Group n=7 Participants Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=10 Participants Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=11 Participants Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period
Brain Activity (Measured by Functional Magnetic Resonance Imaging) in a Priori Regions of Interest, in Response to Standardized Smoking vs Nonsmoking Cues.	0.021 percent change in BOLD signal Standard Deviation 0.089	-0.025 percent change in BOLD signal Standard Deviation 0.080	0.035 percent change in BOLD signal Standard Deviation 0.120

PRIMARY outcome

Timeframe: [Time Frame: For 822815, fMRI scan 1 (at least 2 weeks after initial enrollment); for 850796, fMRI scan 1 (at least 6 weeks after initial enrollment)]]

In key neural cue reactivity regions (based on prior work), we will extract estimates of neural activity during exposure to images showing the cash register area at a convenience store which sells tobacco products, and has tobacco products and tobacco marketing on display behind the register (the "power wall"; tobacco retail images), and during exposure to nonsmoking cues. We used SPM12 to create first-level (within-subject) linear regression models to estimate BOLD (blood oxygenation level dependent) activity at each voxel across all repetitions of each task condition, within each subject; and to create contrast estimates comparing task conditions. We used nilearn tools to average task condition contrast estimates across voxels within the regions of interest for each participant. The data values below reflect this contrast estimate - the difference in neural activity as percent change in BOLD signal between the retail smoking cues condition and the nonsmoking cues condition.

Outcome measures

Outcome measures
Measure	Tobacco Retailer Group n=7 Participants Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=10 Participants Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=11 Participants Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period
Brain Activity (Measured by fMRI), in a Priori Regions of Interest, in Response to Retail Smoking vs Nonsmoking Cues	0.062 percent change in BOLD signal Standard Deviation 0.118	0.012 percent change in BOLD signal Standard Deviation 0.092	0.018 percent change in BOLD signal Standard Deviation 0.108

Adverse Events

Tobacco Retailer Group

Serious events: 2 serious events

Other events: 0 other events

Deaths: 0 deaths

Non-tobacco Retailer Group

Serious events: 5 serious events

Other events: 0 other events

Deaths: 0 deaths

Control

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Unassigned

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure	Tobacco Retailer Group n=109 participants at risk Participants visit a tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Tobacco retailer: Assigned to make a small (\~$3.00) purchase from a tobacco retail store(s) using a study-provided debit card during each retail environment visit	Non-tobacco Retailer Group n=109 participants at risk Participants visit a non-tobacco retailer 5 times per week during the 4-week (20 store visits total) intervention period Non-tobacco retailer: Assigned to make a small (\~$3.00) purchase from a store that does not sell tobacco (non-tobacco retailer) using a study-provided debit card during each retail environment visit.	Control n=76 participants at risk Participants are not asked to alter their behavior during the 4-week (0 store visits) intervention period	Unassigned n=49 participants at risk Participants who began the baseline period, but did not begin the intervention period and therefore were not assigned to an experimental group.
General disorders Hospitalization	1.8% 2/109 • Period of enrollment for each participant (approximately 6 weeks)	4.6% 5/109 • Period of enrollment for each participant (approximately 6 weeks)	0.00% 0/76 • Period of enrollment for each participant (approximately 6 weeks)	0.00% 0/49 • Period of enrollment for each participant (approximately 6 weeks)

Other adverse events

Adverse event data not reported

Additional Information

Emily Falk

University of Pennsylvania

Phone: 215-573-9901

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place