Predictors of Utilization of a Novel Smoking Cessation Smartphone App

Abstract

Background: Understanding the characteristics of high and low utilizers of smartphone applications (apps) for smoking cessation would inform development of more engaging and effective apps, yet no studies to date have addressed this critical question. Informed by prior research on predictors of cessation Web site utilization, this study examines the degree to which baseline demographic factors (gender, age, and education), smoking-related factors (smoking level and friends' smoking), and psychological factors (depression and anxiety) are predictive of utilization of a smartphone app for smoking cessation called SmartQuit. Materials and Methods: Data came from 98 participants randomized to SmartQuit as part of a pilot trial from March to May 2013. We used negative binomial count regressions to examine the relationship between user characteristics and utilization of the app over an 8-week treatment period. Results: Lower education (risk ratio [RR] = 0.492; p = 0.021), heavier smoking (RR = 0.613; p = 0.033), and depression (RR = 0.958; p = 0.017) prospectively predicted lower app utilization. Women (RR = 0.320; p = 0.022), those with lower education (RR = 0.491; p = 0.013), and heavier smokers (RR = 0.418; p = 0.039) had lower utilization of app features known to predict smoking cessation. Conclusions: Many of the predictors of utilization of smoking cessation apps are the same as those of cessation Web sites. App-delivered smoking cessation treatment effectiveness could be enhanced by focusing on increasing engagement of women, those with lower education, heavy smokers, and those with current depressive symptoms.

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

“…Other randomised controlled trials comparing two mobile applications using action and commitment theory reported 13% (95% CI,6-22%) quit rate in the intervention (ATC based smart application) versus 8% (95% CI, 3-16%) in control groups (Quit Guide app) 36 . The odds of quitting were 2.9%, (95% CI 0.8-10.3).Two studies measuring 8-weeks cessation rate compared to conventional treatment only and full app adherence post-intervention were two times and four times more likely to achieve cessation, respectively 30,32 . When comparing the smartphone mobile applications with text message smoking cessation support, significantly higher number of quitters were found among the text message support group.…”

“…However, in interventional studies, the average number of the application openings was only 8.5 (SD = 9). Young age, knowledge level, heavier smoking, depression were predictive factors for app utilization studied in three studies 29,32,34 . Audio-visual features were most used aspects of the application followed by quit plan, tracking process and sharing features.…”

“…The majority of the studies were conducted in the United States [29][30][31][32][33] . One unique intervention of mobile apps on the tablet was conducted among randomly selected hospital patients.…”

“…Two studies included were a post-hoc analysis of the single arm pilot randomised control trials 31,32 . Three studies did not have a control group 29,33,34 .…”

“…Two studies included hospital patient and smoking cessation clinic clients 29,35 . One study used an online screening survey for recruitment 32 . The format of delivery of intervention varied with each study.…”