Feature-level analysis of a novel smartphone application for smoking cessation

Abstract

Background: Currently, there are over 400 smoking cessation smartphone apps available, downloaded an estimated 780,000 times per month. No prior studies have examined how individuals engage with specific features of cessation apps and whether use of these features is associated with quitting. Objectives: Using data from a pilot trial of a novel smoking cessation app, we examined: (i) the 10 most-used app features, and (ii) prospective associations between feature usage and quitting. Methods: Participants (n = 76) were from the experimental arm of a randomized, controlled pilot trial of an app for smoking cessation called “SmartQuit,” which includes elements of both Acceptance and Commitment Therapy (ACT) and traditional cognitive behavioral therapy (CBT). Utilization data were automatically tracked during the 8-week treatment phase. Thirty-day point prevalence smoking abstinence was assessed at 60-day follow-up. Results: The most-used features – quit plan, tracking, progress, and sharing – were mostly CBT. Only two of the 10 most-used features were prospectively associated with quitting: viewing the quit plan (p = 0.03) and tracking practice of letting urges pass (p = 0.03). Tracking ACT skill practice was used by fewer participants (n = 43) but was associated with cessation (p = 0.01). Conclusions: In this exploratory analysis without control for multiple comparisons, viewing a quit plan (CBT) as well as tracking practice of letting urges pass (ACT) were both appealing to app users and associated with successful quitting. Aside from these features, there was little overlap between a feature’s popularity and its prospective association with quitting. Tests of causal associations between feature usage and smoking cessation are now needed.

• ACT
• app
• mHealth
• mobile phone
• tobacco

Acknowledgements

This study was funded by a grant from the Fred Hutchinson Cancer Research Center (Hartwell Innovation Fund, to JBB). The writing of this manuscript was supported by grants from the National Institutes of Health (K23DA026517 to JLH, T32MH082709 to RV, and R01CA166646 and R01CA151251 to JBB). The authors wish to thank Katrina Akioka, Madelon Bolling, PhD, Jessica Harris, MA, Kristin Mull, MS, and Jo Masterson and Brandon Masterson of 2Morrow, Inc., for their assistance on the project.

Declaration of interest

The Fred Hutchinson Cancer Research Center has filed a US patent for the app described in the manuscript (SmartQuit) that is now pending. The SmartQuit app is not yet publically available, although a commercial version is being developed by 2Morrow Inc., with support from the Washington State Life Sciences Discovery Fund (grant #LSDF12328761).The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.