Smokers’ Views on Personal Carbon Monoxide Monitors, Associated Apps, and Their Use: An Interview and Think-Aloud Study

Herbeć, Aleksandra; Perski, Olga; Shahab, Lion; West, Robert

doi:10.3390/ijerph15020288

Cited by 19 publications

(30 citation statements)

References 53 publications

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“…A recent qualitative study documented that smokers are interested in using the iCO, particularly for purposes of smoking cessation. 54 Although the iCO has the potential to make remote CO collection possible in any smoking study, existing video verification protocols cannot be used with the iCO because the device does not have a screen to directly display a CO reading. The iCO functions only when used in conjunction with a mobile app developed by Bedfont.…”

Section: Remote Biomarkers Collectionmentioning

confidence: 99%

Remote Methods for Conducting Tobacco-Focused Clinical Trials

Dahne

Tomko

McClure

et al. 2020

Nicotine &Amp; Tobacco Research

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Abstract Most tobacco-focused clinical trials are based on locally conducted studies that face significant challenges to implementation and successful execution. These challenges include the need for large, diverse, yet still representative study samples. This often means a protracted, costly, and inefficient recruitment process. Multisite clinical trials can overcome some of these hurdles but incur their own unique challenges. With recent advances in mobile health and digital technologies, there is now a promising alternative: Remote Trials. These trials are led and coordinated by a local investigative team, but are based remotely, within a given community, state, or even nation. The remote approach affords many of the benefits of multisite trials (more efficient recruitment of larger study samples) without the same barriers (cost, multisite management, and regulatory hurdles). The Coronavirus Disease 2019 (COVID-19) global health pandemic has resulted in rapid requirements to shift ongoing clinical trials to remote delivery and assessment platforms, making methods for the conduct of remote trials even more timely. The purpose of the present review is to provide an overview of available methods for the conduct of remote tobacco-focused clinical trials as well as illustrative examples of how these methods have been implemented across recently completed and ongoing tobacco studies. We focus on key aspects of the clinical trial pipeline including remote: (1) study recruitment and screening, (2) informed consent, (3) assessment, (4) biomarker collection, and (5) medication adherence monitoring. Implications With recent advances in mobile health and digital technologies, remote trials now offer a promising alternative to traditional in-person clinical trials. Remote trials afford expedient recruitment of large, demographically representative study samples, without undo burden to a research team. The present review provides an overview of available methods for the conduct of remote tobacco-focused clinical trials across key aspects of the clinical trial pipeline.

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Section: Remote Biomarkers Collectionmentioning

confidence: 99%

Remote Methods for Conducting Tobacco-Focused Clinical Trials

Dahne

Tomko

McClure

et al. 2020

Nicotine &Amp; Tobacco Research

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“…For example, Iacoviello et al reported that the Clickotine smartphone app for smoking cessation achieved a 30% CAR at 8 weeks 15 . In addition, the feasibility of a mobile phone or an internet-based personal exhaled carbon monoxide (CO) measurement tool has been reported [14][15][16][17][18][19][20] . For example, Alessi and Wilson conducted studies to investigate the usability and feasibility of monitoring the concentration of exhaled CO by using mobile phones 19,20 .…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of a smoking cessation smartphone application with a carbon monoxide checker

et al. 2020

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Evidence of the long-term efficacy of digital therapies for smoking cessation that include a smartphone application (app) is limited. In this multi-center randomized controlled trial, we tested the efficacy of a novel digital therapy for smoking cessation: the "CureApp Smoking Cessation (CASC)" system, including a CASC smartphone app, a web-based patient management PC software for primary physicians, and a mobile exhaled carbon monoxide (CO) checker. A total of 584 participants with nicotine dependence were recruited from October 2017 to January 2018, and allocated 1:1 to the CASC intervention group or the control group. Both groups received a standard smoking cessation treatment with pharmacotherapy and counseling for 12 weeks. Meanwhile, the intervention group used the CASC system, and the control group used a control-app without a mobile CO checker, each for 24 weeks. The primary outcome was the biochemically validated continuous abstinence rate (CAR) from weeks 9 to 24. The main secondary outcome was an extended CAR from weeks 9 to 52. Except for 12 participants who did not download or use the apps, 285 participants were assigned to the intervention group, and 287, to the control. CAR from weeks 9 to 24 in the intervention group was significantly higher than that in the control group (63.9% vs. 50.5%; odds ratio [OR], 1.73; 95% confidence interval [CI], 1.24 to 2.42; P = 0.001). The CAR from weeks 9 to 52 was also higher in the intervention group than that in the control group (52.3% vs. 41.5%; OR, 1.55; 95% CI, 1.11 to 2.16; P = 0.010). No specific adverse events caused by the CASC system were reported. Augmenting standard face-to-face counseling and pharmacotherapy with a novel smartphone app, the CASC system significantly improved long-term CARs compared to standard treatment and a minimally supportive control app.

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“…During the initial meeting with the researcher, participants were trained in the study procedures and downloaded one of two possible HR apps that met predefined criteria (not requiring registration, being free of charge, and having among the highest ratings on app stores): “Instant Heart Rate” or “Cardiio.” The participants were also provided with a personal CO monitor 9 , 17 manufactured by Bedfont Scientific Ltd (see Supplementary Material 1 ). Participants were asked to choose 3 days when they would measure their HR (did not need to be consecutive days), all of which had to be within 10 days of providing consent.…”

Section: Methodsmentioning

confidence: 99%

Decrease in Resting Heart Rate Measured Using Smartphone Apps to Verify Abstinence From Smoking: An Exploratory Study

Herbeć

Parker

Ubhi

et al. 2020

Nicotine &Amp; Tobacco Research

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Introduction Verifying self-reports of smoking abstinence is challenging in studies that involve remote data collection. Resting heart rate (HR) decreases during smoking abstinence. This study assessed whether a decrease in resting HR measured using freely available smartphone apps could potentially be used to verify smoking abstinence. Methods This study involved a repeated measures experimental design, with data collection in natural setting. Participants were 18 adult, daily smokers. They recorded resting HR in beats per minute (bpm) using freely available smartphone apps during five timepoints (two in the morning and three postnoon) on each of 3 days. The outcome measure was the mean of the postnoon HR recordings. The experimental condition for each of the 3 days (counterbalanced order) was as follows: (1) smoking as usual, (2) not smoking without nicotine replacement therapy (NRT), or (3) not smoking but using NRT. Abstinence was verified using expired-air carbon monoxide (CO) concentration. Results Compared with the smoking as usual condition, mean HR was 13.4 bpm lower (95% confidence interval [CI] = 5.4 to 21.4, p = .001) in the not smoking without NRT condition and 10.4 bpm lower (95% CI = 3.1 to 17.8, p = 0.004) in the not smoking with NRT condition. There was no statistically significant difference in HR between the two not smoking conditions (p = .39). Abstinence during not smoking days without and with NRT was CO-verified in 18/18 and in 16/18 cases, respectively. Conclusions Self-recording of resting HR in natural setting using smartphone apps shows a reliable decrease in response to smoking abstinence and may provide a basis for remote verification in smoking cessation studies. Implications Remote verification of self-reported abstinence in smoking cessation studies remains challenging. Smoking abstinence has been shown to decrease resting HR under laboratory conditions. This study demonstrated that self-recording using freely available smartphone apps shows reliable decreases in resting HR during smoking abstinence and may provide a basis for inexpensive remote verification of smoking abstinence.

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Smokers’ Views on Personal Carbon Monoxide Monitors, Associated Apps, and Their Use: An Interview and Think-Aloud Study

Cited by 19 publications

References 53 publications

Remote Methods for Conducting Tobacco-Focused Clinical Trials

Remote Methods for Conducting Tobacco-Focused Clinical Trials

A randomized controlled trial of a smoking cessation smartphone application with a carbon monoxide checker

Decrease in Resting Heart Rate Measured Using Smartphone Apps to Verify Abstinence From Smoking: An Exploratory Study

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