Randomized Trial of a Smartphone Mobile Application Compared to Text Messaging to Support Smoking Cessation

Abstract

Background: Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Materials and Methods: Young adult smokers 18-30 years old (n = 102) participated in a randomized pretest-posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Selfreported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Results: Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (p < 0.05) than REQ-Mobile. Use of both services predicted increased 30-day abstinence at 12 weeks (used, 47%; not used, 20%; p = 0.03). Conclusions: REQ-Mobile was feasible for delivering cessation support but appeared to not move smokers to quit as quickly as text messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging.

A systematic review of smartphone applications for smoking cessation

“…While some apps have shown promise in small randomized trials for promoting changes in smoking, including point prevalence abstinence, none have been tested with fully powered studies [21,22,25]. Apparent turnover of apps, inconsistent quality, varying results between search terms, and irrelevant app suggestions are significant barriers for consumers seeking scientifically supported health apps.…”

“…Heath apps offer functionality which allows users to receive reminders for health appointments and medication adherence for chronic conditions such as diabetes, while others offer accessible, real-time, monitoring and social support for behavioral health conditions such as tobacco addiction [19]. With the ubiquity of the mobile phone, and the potential for flexible treatment options to reach more people, research about health apps is on the rise, although, few studies have examined the quality of content or the effectiveness of apps promoting smoking cessation [21][22][23][24][25][26][27].…”

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

“…Six studies adopted automated data extraction from the application. Four studies 30,31,33,34,36 included automated motivational messages while another included a specific daily educational module on smoking cessation . Most studies have adopted a quit plan, pictorial and audio-visual, cost saving, coping skills, and social support features in the application for smoking cessation.…”

Realising the technological promise of smartphones in addiction research and treatment: An ethical review

“…There is great potential of mHealth technology, yet it is imperative that we first address these ethical considerations to ensure that we capitalise on the possible benefits of these technologies while minimising the potential risks to the users. BinDhim et al, 2014;Borland et al, 2013;Bricker et al, 2014;Buller et al, 2014;Haug et al, 2014;Hertzberg et al, 2013;Kirchner et al, 2013;Meredith et al, 2014;V. Patel, Nowostawski, Thomson, Wilson, & Medlin, 2013;Ploderer et al, 2014;Reitzel et al, 2014; Whittaker, 2011) Alcohol 12 (34.3%) (Bendtsen & Bendtsen, 2014;Dulin et al, 2014;Gajecki et al, 2014;Gamito et al, 2014;Haug et al, 2014;Kauer, Reid, Sanci, & Patton, 2009;Matsumura, Yamakoshi, & Ida, 2009;McTavish et al, 2012;Renner, 2012;Yu et al, 2012) Heroin 2 (5.7%) Epstein et al, 2009) Cocaine 1 (2.9%) (Freedman, Lester, McNamara, Milby, & Schumacher, 2006) General 3 (8.6%) (Campling, 2011;Ingersoll et al, 2014; Bendtsen & Bendtsen, 2014;BinDhim et al, 2014;Borland et al, 2013;Bricker et al, 2014;Buller et al, 2014;Dulin et al, 2014;Hasin et al, 2014;Haug et al, 2014;Ingersoll et al, 2014;Ploderer et al, 2014;…”

“…However, almost half of the studies did not provide any resources or clinically relevant information for users. Finally, six apps were developed alongside not-for-profit, independent organisations, such as Quit Victoria (Ploderer, Smith, Pearce, & Borland, 2014) or the Cancer Council (Borland, Balmford, & Benda, 2013;Buller, Borland, Bettinghaus, Shane, & Zimmerman, 2014).…”