Prevalence and Frequency of mHealth and eHealth Use Among US and UK Smokers and Differences by Motivation to Quit

Abstract

BackgroundBoth mHealth and eHealth interventions for smoking cessation are rapidly being developed and tested. There are no data on use of mHealth and eHealth technologies by smokers in general or by smokers who are not motivated to quit smoking.ObjectiveThe aims of our study were to (1) assess technology use (eg, texting, social media, Internet) among smokers in the United States and United Kingdom, (2) examine whether technology use differs between smokers who are motivated to quit and smokers who are not motivated to quit, (3) examine previous use of technology to assist with smoking cessation, and (4) examine future intentions to use technology to assist with smoking cessation.MethodsParticipants were 1000 adult smokers (54.90%, 549/1000 female; mean age 43.9, SD 15.5 years; US: n=500, UK: n=500) who were recruited via online representative sampling strategies. Data were collected online and included demographics, smoking history, and frequency and patterns of technology use.ResultsAmong smokers in general, there was a high prevalence of mobile and smartphone ownership, sending and receiving texts, downloading and using apps, using Facebook, and visiting health-related websites. Smokers who were unmotivated to quit were significantly less likely to own a smartphone or handheld device that connects to the Internet than smokers motivated to quit. There was a significantly lower prevalence of sending text messages among US smokers unmotivated to quit (78.2%, 179/229) versus smokers motivated to quit (95.0%, 229/241), but no significant differences between the UK groups (motivated: 96.4%, 239/248; unmotivated: 94.9%, 223/235). Smokers unmotivated to quit in both countries were significantly less likely to use a handheld device to read email, play games, browse the Web, or visit health-related websites versus smokers motivated to quit. US smokers had a high prevalence of app downloads regardless of motivation to quit, but UK smokers who were motivated to quit had greater prevalence of app downloads than smokers unmotivated to quit. US smokers were significantly more likely to have a Facebook account (87.0%, 435/500) than UK smokers (76.4%, 382/500), but smokers unmotivated to quit in both countries used Facebook less frequently than smokers motivated to quit. Smokers who were unmotivated to quit were less likely to have used eHealth or mHealth platforms to help them quit smoking in the past and less likely to say that they would use them for smoking cessation in the future.ConclusionsAlthough smokers unmotivated to quit make less use of technology than smokers motivated to quit, there is sufficient prevalence to make it worthwhile to develop eHealth and mHealth interventions to encourage cessation. Short and low-effort communications, such as text messaging, might be better for smokers who are less motivated to quit. Multiple channels may be required to reach unmotivated smokers.

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

“…Studies have shown inconsistent correlation on app utilization and acceptance. Online and mHealth studies face challenges regarding ideal participant yield and fluctuating costs of online recruitment 19,48 . The theory based app features are employed in our studies with limited information on the quality of this evidence.…”

“…One comparative study suggested a large number of smokers use the smartphone to send and receive texts, download apps, use Facebook, and browse health-related internet sites 19 . Evaluation of evidence of the impact and cost-effectiveness of mHealth services is imperative, as the modifiable gap in communication persists between healthcare professionals and smokers 20 .…”

Warm Handoff Versus Fax Referral for Linking Hospitalized Smokers to Quitlines

“…A call within the first week of a quit attempt post-discharge would be ideal, as many smokers relapse within the first week of discharge. 51 Until smokers feel able to participate in real-time counseling, asynchronous methods for interacting with smokers, such as text messaging or other mobile or Internet methods, 52 might help them stay committed to quitting during their post-hospital recuperation. Text messaging has the added advantage of being a low-cost, effective method for smoking cessation that is globally affordable.…”

Social Networks and Smoking in Rural Women: Intervention Implications

“…Of late, scholars have been focusing on the use of technology in smoking cessation interventions. 41–43 Although this may have merit, scholars have found the use of technology to be dependent on one’s motivation to quit, 41 to vary by participant characteristic (eg, women, low education, heavy smokers were less likely to use cessation apps), 43 and by population group. 42 Future research may benefit by testing how mobile apps could be used in conjunction with face-to-face mode of content delivery.…”