“Appagalo” a Customized Mobile Health Intervention (mHealth) for Smoking Cessation in Women: A Randomized Controlled Trial

Abstract

BACKGROUND Almost 30% of Chilean women report cigarette smoking with important repercussions on their health. OBJECTIVE Design and test a mobile phone intervention for smoking cessation in young women. STUDY DESIGN A mobile application (app) was created using the best available evidence and consumer input. Its effectiveness was assessed through a randomized clinical trial. STUDY PARTICIPANTS Women 18 to 44 years old from middle-class neighborhoods in Santiago, Chile. Inclusion criteria were intention to quit cigarette smoking in the following month and having a smartphone cell phone. Women with positive screening for risky alcohol consumption were excluded. INTERVENTION App with content to support cigarette smoking cessation over 6 months. The control arm included an app that delivered general messages to promote permanence in the study. Telephone follow-up was performed at 6 weeks, and at 3 and 6 months after randomization. MAIN OUTCOME MEASURE No smoking in the past 7 days at 6 weeks from enrolment. Intention-to-treat analysis was carried out using SPSS 17.0 with a significance level set at .05. RESULTS 309 women entered the study. Mean number of cigarettes smoked in a day was 8.8. 58.6% of the participants (n = 181) completed the follow-up for the primary outcome. With intention-to-treat analysis, 9.7% of participants in the intervention group reported not having smoked any cigarettes in the last 7 days vs 3.2% in the control group (RR 2.98 CI 95% 1.11-8.0, P = .022). Additionally, 12.3% vs 1.9% of the participants in the intervention group and control group reported continuous abstinence at 6 weeks, respectively (RR 6.29 95% CI 1.9-20.8, P < .001). Continuous abstinence was also significant at 6 months ( P-value of .036). CONCLUSIONS The “Appagalo” app is an effective tool to support smoking cessation in young women. It is a simple mHealth alternative for smoking cessation that can contribute to improving women's health in the Americas and worldwide.

Avoid Smoking: mHealth Evidence and Theory-Based Intervention to Promote Smoking Prevention Behaviors

“…Evidence-based mhealth interventions can confirm the efficacy of health promotion programs. Several studies have shown the usefulness of mhealth interventions in preventing high-risk behaviors such as smoking, substance abuse, and alcohol consumption (33)(34)(35)(36). Moreover, Moore et al reported that the smoking abstinence rate in these interventions was generally 1.5 times higher than the control group (37).…”

Pilot Testing of an mHealth App for Tobacco Cessation in People Living With HIV: Protocol for a Pilot Randomized Controlled Trial

“…Smartwatch technology has been developed and tested in interventional smoking cessation studies within the past decade, yet study samples have been small, and more testing is required to improve the accuracy of smoking detection [40][41][42][43]. Similarly, mHealth has been used for smoking cessation and has been found to be effective in the short term [44][45][46][47][48][49][50][51], with little evidence of efficacy in the long term [52]. A systematic review of quit-smoking apps in Android's Play Store and Apple's App Store found high rates of existing irrelevant or nonfunctioning apps and few apps with evidence-based support [53].…”