Combined Ecological Momentary Assessment and Global Positioning System Tracking to Assess Smoking Behavior: A Proof of Concept Study

Abstract

Objective: Ecological momentary assessment (EMA) methods have provided a rich assessment of the contextual factors associated with a wide range of behaviors including alcohol use, eating, physical activity, and smoking. Despite this rich database, this information has not been linked to specific locations in space. Such location information, which can now be easily acquired from global positioning system (GPS) tracking devices, could provide unique information regarding the space-time distribution of behaviors and new insights into their determinants. In a proof of concept study, we assessed the acceptability and feasibility of acquiring and combining EMA and GPS data from adult smokers with attention deficit hyperactivity disorder (ADHD). Methods: Participants were adults with ADHD who were enrolled in a larger EMA study on smoking and psychiatric symptoms. Among those enrolled in the latter study who were approached to participate (N = 11), 10 consented, provided daily EMA entries, and carried a GPS device with them during a 7-day assessment period to assess aspects of their smoking behavior. Results: The majority of those eligible to participate were willing to carry a GPS device and signed the consent (10 out of 11, 91%). Of the 10 who consented, 7 participants provided EMA entries and carried the GPS device with them daily for at least 70% of the sampling period. Data are presented on the spatial distribution of smoking episodes and ADHD symptoms on a subset of the sample to demonstrate applications of GPS data. Conclusions: We conclude by discussing how EMA and GPS might be used to study the ecology of smoking and make recommendations for future research and analysis.

Keywords:

• global positioning system
• geographic information system
• ecological momentary assessment
• nicotine dependence
• smoking
• ADHD

ACKNOWLEDGMENTS

We thank Amy Brightwood, Joseph English, and Becca Bayham for assistance with data collection.

Findings from this study have been presented at the annual meeting for the Society for Research on Nicotine and Tobacco, Boston, MA, March 13–16, 2013; the annual meeting for the Society of Behavioral Medicine, San Francisco, CA, March 20–23, 2013; and the inaugural mHealth Conference at Duke University, Durham, NC, April 15, 2013.