A content analysis of smartphone apps for adolescent smoking cessation

Robinson, Cendrine; Seaman, Elizabeth L; Grenen, Emily; Montgomery, LaTrice; Yockey, R. Andrew; Coa, Kisha; Prutzman, Yvonne; Augustson, Erik

doi:10.1093/tbm/iby113

Cited by 21 publications

(16 citation statements)

References 25 publications

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“…The landscape of smoking cessation apps is rapidly changing. Currently available apps are variable in their content and features [ 27 , 29 , 55 - 58 ], and few contain content that adheres to clinical practice guidelines [ 27 , 55 - 57 , 59 - 61 ]. A recent literature review [ 29 ] found that most smoking cessation apps included self-tracking features, but only one-third included social support and one-third included rewards systems.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of Mobile Apps for Smoking Cessation Among Young People in Community Mental Health Care: Qualitative Study

Gowarty¹,

Kung²,

Maher³

et al. 2020

JMIR Form Res

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Background Young adults with serious mental illness are over twice as likely to have tobacco use disorder than those in the general population and are less likely to utilize proven treatment methods during quit attempts. However, little research has evaluated the efficacy of interventions for this group. Smartphone apps may be an underutilized tool for tobacco use disorder among young adults with serious mental illness. Objective The aim of this study was to explore attitudes toward smoking cessation apps and preferences regarding app design in young adult smokers with serious mental illness. Methods Five focus groups involving 25- to 35-year-old adults with serious mental illness receiving treatment at a community mental health center were conducted between May 2019 and August 2019. Three researchers independently coded transcripts and identified themes using thematic analysis. Results Participants (n=22) were individuals who smoke daily: 10 (46%) self-identified as female, 18 (82%) self-identified as White, and 9 (41%) had psychotic disorders. Key themes that emerged included a general interest in using health apps; a desire for apps to provide ongoing motivation during a quit attempt via social support, progress tracking, and rewards; a desire for apps to provide distraction from smoking; concerns about app effectiveness due to a lack of external accountability; and concerns that apps could trigger cravings or smoking behavior by mentioning cigarettes or the act of smoking. Conclusions Apps have the potential to support smoking cessation or reduction efforts among young adults with serious mental illness. However, they may require tailoring, optimization, and clinical support to effectively promote cessation in this population.

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Section: Discussionmentioning

confidence: 99%

Perceptions of Mobile Apps for Smoking Cessation Among Young People in Community Mental Health Care: Qualitative Study

Gowarty¹,

Kung²,

Maher³

et al. 2020

JMIR Form Res

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“…Recent findings demonstrate that young adults with SMI value these and other app features, suggesting that apps may be well suited to deliver smoking cessation support to this population [12]. Although hundreds of smartphone apps are available for smoking cessation, they vary widely in their content and features [11,[13][14][15][16][17]. To our knowledge, none have been evaluated for usability, appeal, or effectiveness in young adults with SMI.…”

Section: Introductionmentioning

confidence: 99%

“…The National Cancer Institute (NCI) provides 2 smoking cessation apps based on behavioral change theories and clinical practice guidelines [11,[14][15][16]18,19]-one designed for adults (QuitGuide) and the other designed for teens (quitSTART). These apps vary considerably in their content, layout, and design.…”

Section: Introductionmentioning

confidence: 99%

Usability and Acceptability of Two Smartphone Apps for Smoking Cessation Among Young Adults With Serious Mental Illness: Mixed Methods Study

Gowarty¹,

Longacre²,

Vilardaga³

et al. 2021

JMIR Ment Health

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Background Young adults with serious mental illness (SMI) have higher smoking rates and lower cessation rates than young adults without SMI. Scalable interventions such as smartphone apps with evidence-based content (eg, the National Cancer Institute’s [NCI’s] QuitGuide and quitSTART) could increase access to potentially appealing and effective treatment for this group but have yet to be tested in this population. Objective The goal of this user-centered design study is to determine the user experience (including usability and acceptability) of 2 widely available apps developed by the NCI—QuitGuide and quitSTART—among young adult tobacco users with SMI. Methods We conducted usability and acceptability testing of QuitGuide and quitSTART among participants with SMI aged between 18 and 35 years who were stable in community mental health treatment between 2019 and 2020. Participants were randomly assigned to use QuitGuide or quitSTART on their smartphones. App usability was evaluated at baseline and following a 2-week field test of independent use via a video-recorded task completion protocol. Using a mixed method approach, we triangulated 4 data sources: nonparticipant observation, open-ended interviews, structured interviews (including the System Usability Scale [SUS]), and backend app use data obtained from the NCI. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using thematic analysis. Results Participants were 17 smokers who were not interested in quitting, with a mean age of 29 (SD 4) years; 41% (n=7) presented with psychotic disorders. Participants smoked an average of 15 (SD 7) cigarettes per day. The mean SUS scores for QuitGuide were similar at visits one and two (mean 64, SD 18 and mean 66, SD 18, respectively). The mean SUS scores for quitSTART numerically increased from visit one (mean 55, SD 20) to visit two (mean 64, SD 16). Acceptability scores followed the same pattern. Observed task completion rates were at least 75% (7/9 for QuitGuide, 6/8 for quitSTART) for both apps at both visits for all but 2 tasks. During the 13-day trial period, QuitGuide and quitSTART users interacted with their assigned app on an average of 4.6 (SD 2.8) days versus 10.8 (SD 3.5) days, for a mean total of 5.6 (SD 3.8) interactions versus 41 (SD 26) interactions, and responded to a median of 1 notification (range 0-8) versus 18.5 notifications (range 0-37), respectively. Qualitative comments indicated moderate to high satisfaction overall but also included concerns about the accuracy of the apps’ feedback. Conclusions Both QuitGuide and quitSTART had acceptable levels of usability and mixed levels of acceptability among young adults with SMI. The higher level of engagement with quitSTART suggests that quitSTART may be a favorable tool for young adult smokers with SMI. However, clinical support or coaching may be needed to overcome initial usability issues.

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“…We know that most attempts to quit smoking are not successful; according to the Centers for Disease Control and Prevention, only 12.2% of those who try to stop smoking remain abstinent [ 3 ]. For this reason, interventions that help young people and the general population stop smoking are needed.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of Spain, between 80% and 90% of the population have at least one smartphone [ 1 ], which places the country at the top of European mobile phone usage, with 23 million people owning smartphones [ 2 ]. Mobile apps provide an accessible way to test new health-related methodologies, which also address user concerns around the availability and confidentiality of their personal data [ 3 ]. In Spain, users download around 4 million apps every day and, more importantly, two-thirds of teenagers (and young users) downloaded and used a mobile health app in the last year.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Tobbstop Mobile App for Smoking Cessation: Cluster Randomized Controlled Clinical Trial

Pallejà-Millán¹,

Rey-Reñones²,

Uriarte³

et al. 2020

JMIR Mhealth Uhealth

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Background Mobile apps provide an accessible way to test new health-related methodologies. Tobacco is still the primary preventable cause of death in industrialized countries, constituting an important public health issue. New technologies provide novel opportunities that are effective in the cessation of smoking tobacco. Objective This paper aims to evaluate the efficacy and usage of a mobile app for assisting adult smokers to quit smoking. Methods We conducted a cluster randomized clinical trial. We included smokers older than 18 years who were motivated to stop smoking and used a mobile phone compatible with our mobile app. We carried out follow-up visits at 15, 30, and 45 days, and at 2, 3, 6, and 12 months. Participants of the intervention group had access to the Tobbstop mobile app designed by the research team. The primary outcomes were continuous smoking abstinence at 3 and 12 months. Results A total of 773 participants were included in the trial, of which 602 (77.9%) began the study on their D-Day. Of participants in the intervention group, 34.15% (97/284) did not use the app. The continuous abstention level was significantly larger in the intervention group participants who used the app than in those who did not use the app at both 3 months (72/187, 38.5% vs 13/97, 13.4%; P<.001) and 12 months (39/187, 20.9% vs 8/97, 8.25%; P=.01). Participants in the intervention group who used the app regularly and correctly had a higher probability of not being smokers at 12 months (OR 7.20, 95% CI 2.14-24.20; P=.001) than the participants of the CG. Conclusions Regular use of an app for smoking cessation is effective in comparison with standard clinical practice. Trial Registration Clinicaltrials.gov NCT01734421; https://clinicaltrials.gov/ct2/show/NCT01734421

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A content analysis of smartphone apps for adolescent smoking cessation

Cited by 21 publications

References 25 publications

Perceptions of Mobile Apps for Smoking Cessation Among Young People in Community Mental Health Care: Qualitative Study

Perceptions of Mobile Apps for Smoking Cessation Among Young People in Community Mental Health Care: Qualitative Study

Usability and Acceptability of Two Smartphone Apps for Smoking Cessation Among Young Adults With Serious Mental Illness: Mixed Methods Study

Evaluation of the Tobbstop Mobile App for Smoking Cessation: Cluster Randomized Controlled Clinical Trial

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