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Chen S, Tang J, Wu C, Zhang G, Zhang J, Liao Y. Preliminary Efficacy of a Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial. JMIR Form Res 2024; 8:e48050. [PMID: 38498030 PMCID: PMC10985609 DOI: 10.2196/48050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/27/2023] [Accepted: 09/28/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The overall prevalence of cigarette smokers in China is very high, and China's total cigarette consumption makes up more than 40% of the world's consumption. In view of the lack of smoking cessation services and social support in China and the effectiveness of mobile phone apps for quitting smoking in other countries, we carried out a smartphone app-based smoking cessation trial in China. OBJECTIVE This study aimed to evaluate the efficacy of a cognitive behavioral therapy (CBT)-based smoking cessation smartphone app among smokers seeking treatment in China. METHODS We conducted a randomized controlled, web-based pilot clinical trial in China between February 23 and June 27, 2021. Eligible participants were randomly assigned to the smoking cessation app intervention group or the control group in a ratio of 1:1. The intervention group received the CBT smoking cessation intervention using a smartphone app, and the control group received a "thank you" message. The intervention was 4 weeks long, and the patients were followed up for 4 weeks. The primary outcome was self-reported continuous smoking abstinence at week 4 after the quit date. The secondary outcomes included self-reported 7-day point prevalence of smoking abstinence; reduction of the number of cigarettes smoked per day at weeks 1, 2, 3, and 4; and program acceptability. RESULTS A total of 973 people were recruited to quit smoking, of whom 262 completed basic information, 56 were excluded, and 206 were randomized and included in the final analysis. There were 189 (91.7%) men and 17 (8.3%) women, with an average age of 34.46 (SD 7.53) years and an average daily smoking rate of 15.93 (SD 7.10) cigarettes/day. We found 30 (29.7%) of the 101 participants in the intervention group and 7 (6.7%) of the 105 participants in the control group reported continuous smoking cessation after the quit date at week 4 (odds ratio 5.92, 95% CI 3.78-9.26; P<.001). The 7-day point prevalence abstinence rate of the intervention group varied from 42.6% (43/101) to 46.5% (47/101) after 1, 2, 3, and 4 weeks, while the control group varied from 18.1% (19/105) to 26.7% (28/105). Compared to the control group, continued smokers consumed 1.5-3.0 fewer cigarettes per day in the intervention group. The overall program got positive user feedback with a high satisfaction rate (66/87, 76%) and an average Mobile Application Rating Scale user version score of 3.46. CONCLUSIONS Our pilot study provided preliminary evidence that the CBT-based smoking cessation smartphone app led to improved smoking quit rates versus control in Chinese smokers. The study demonstrated the CBT-based smartphone app may be an effective and feasible digital treatment model to help smokers quit, which may improve smoking cessation service quality and accessibility in China. TRIAL REGISTRATION ClinicalTrials.gov NCT04421170; https://clinicaltrials.gov/study/NCT04421170. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-041985.
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Affiliation(s)
- Shanshan Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Congyang Wu
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Ge Zhang
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Jing Zhang
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Yanhui Liao
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Sweileh WM. Technology-based interventions for tobacco smoking prevention and treatment: a 20-year bibliometric analysis (2003-2022). Subst Abuse Treat Prev Policy 2024; 19:13. [PMID: 38321493 PMCID: PMC10848402 DOI: 10.1186/s13011-024-00595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Substance abuse, particularly tobacco smoking, is a significant global public health concern. Efforts have been made to reduce smoking prevalence and promote cessation, but challenges, such as nicotine addiction, marketing tactics by tobacco industry, and cultural acceptability hinder progress. Technology has emerged as a potential tool to address these challenges by providing innovative scalable interventions. The objective of the study was to analyze and map scientific literature on technology-based intervention for tobacco prevention and treatment. METHODS A bibliometric methodology was conducted. Scopus database was used to retrieve relevant research articles published between 2003 and 2022. The analysis included publication trends, key contributors, research hotspots, research themes, the most impactful articles, and emerging research topics. RESULTS A total of 639 articles were found, with a slow and fluctuating growth pattern observed after 2011. The Journal of Medical Internet Research was the most prominent journal in the field. The United States was the leading country in the field, followed up by the United Kingdom, and the Netherlands. Research hotspots included smoking cessation, randomized controlled trials, and technology-based methods such as internet, mHealth, smartphone apps, text messages, and social media. Four primary research themes were identified: development of smartphone applications, efficacy of text messaging interventions, acceptance and effectiveness of smartphone applications, and interventions targeting young adults and students using mobile phone and social media platforms. The top 10 cited articles demonstrated effectiveness of digital interventions in promoting smoking cessation rates and reducing relapse rates. Emerging research topics included the use of virtual reality interventions, interventions for specific populations through personalized tools, and technology-based interventions in non-Western countries. CONCLUSIONS The findings of the current study highlight the potential of technology to address the challenges associated with tobacco smoking. Further future research in this area is warranted to continue advancing the field and developing effective and evidence-based interventions to combat tobacco smoking.
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Affiliation(s)
- Waleed M Sweileh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Xie X, Liang L, Nan Y, Zhang L, Xiao L. Efficacy of an individual-tailored smoking cessation intervention APP among Chinese smokers: study protocol for a randomized controlled trial. BMC Public Health 2024; 24:65. [PMID: 38166920 PMCID: PMC10763077 DOI: 10.1186/s12889-023-16496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/09/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND AIMS Tobacco use has posed a tremendous public health problem for China. The Chinese government has taken great efforts to curb the tobacco epidemic. However, the existing smoking cessation services available in China are underused and have some limitations. Our research team intends to develop a smartphone smoking cessation application (SSC APP) and integrate it with the existing smoking cessation services. This study aims to assess the efficacy of the SSC APP developed by our research team through a randomized controlled trial (RCT). METHODS Current smokers who are motivated to quit within 1 month (n = 1000) will be recruited both online and offline, and all potential participants will register and complete the prescreening assessment online. Participants will be randomly assigned to either the intervention group (receiving the SSC APP and a self-help smoking cessation manual) or the control group (receiving a self-help smoking cessation manual only) using a block randomization method. This study will be a two-arm, single-blind, parallel-group RCT. Participants will be followed up after enrollment through online questionnaires or by phone call. The primary outcome is self-reported 6-month continuous abstinence. The main secondary outcomes include self-reported 7-day point-prevalence abstinence at each follow-up; self-reported 3-month continuous abstinence; reduction in the number of cigarettes smoked per day; and the number of recent quit attempts. DISCUSSION If this SSC APP proves to be effective, it could be integrated with the existing smoking cessation services and further facilitate smoking cessation at the population level in China. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2200062097, Registered July 22, 2022.
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Affiliation(s)
- Xiaoyun Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 155 Changbai Road Changping District, Beijing, 102206, China
| | - Lirong Liang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Yi Nan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 155 Changbai Road Changping District, Beijing, 102206, China
| | - Luge Zhang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 155 Changbai Road Changping District, Beijing, 102206, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 155 Changbai Road Changping District, Beijing, 102206, China.
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Song J, Chen Y, Zhang Z, Cao Y, Zhang L. Study on the participation of nursing staff in tobacco cessation support and related influencing factors: A survey from Chongqing, China. Tob Induc Dis 2023; 21:131. [PMID: 37842547 PMCID: PMC10568683 DOI: 10.18332/tid/170753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Nursing staff's assistance for smokers to quit smoking can increase the rate of quitting. The smoking cessation help can be affected by many factors. This study surveyed the use of the 5As (Asking, Advising, Assessing, Assisting, Arranging) approach to support smoking cessation by the nursing staff in Chongqing, China, and analyzed the corresponding influencing factors. METHODS A stratified random cluster sampling method was used to select nursing staff from 8 tertiary hospitals, 5 secondary hospitals, 12 community health centers, and 35 township health centers in different geographical regions of Chongqing. A questionnaire survey was conducted among the nursing staff to investigate their participation in smoking cessation. Binary logistic regression analysis was employed to analyze the influencing factors of smoking cessation 5As behavior of the nursing staff. RESULTS The 1669 participants were 44 males (2.6%) and 1625 females (97.4%), with an average age of 37.00 ± 10.89 years. Among the participants, 55.2% were from tertiary hospitals, 23.2% from secondary hospitals, 14.2% from township health centers, and 7.4 from community health centers. The often or always used behaviors were: Asking, 69.2%; Advising, 53.0%; Assessing, 39.5%; Assisting, 33.7%; and Arranging, 25.1%. The factors that affected all the 5As were: smoking cessation training (AOR=1.60; 95% CI: 1.22-2.11), knowledge of smoking cessation guidelines (AOR=1.75; 95% CI: 1.32-2.32) and the use of smoking cessation Apps (AOR=1.50; 95% CI: 1.09-2.06), and smokers' willingness to quit (AOR=2.20; 95% CI: 1.60-3.02). CONCLUSIONS Smoker's motivation to quit smoking and nurses' knowledge of tobacco cessation resources affected nurses' participation in smoking control behavior. While encouraging smokers to quit smoking, clinical nursing staff should be provided with related resources to advocate smoking cessation. Guided by the Chinese Clinical Tobacco Cessation Guidelines, smoking control knowledge and skills training should be provided for nursing staff to increase their positive attitude towards smoking control, so as to promote their active participation.
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Affiliation(s)
- Jun Song
- Department of Ophthalmology, Chongqing General Hospital, Chongqing, People’s Republic of China
| | - Yanhan Chen
- College of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhiyong Zhang
- Integrated Traditional Chinese Medicine and Western Medicine Department, Healthcare Center, Jinlong Town, People’s Republic of China
| | - Yang Cao
- The First People's Hospital of Chongqing High-tech Zone, Chongqing, People’s Republic of China
| | - Li Zhang
- College of Nursing, Chongqing Medical University, Chongqing, People’s Republic of China
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Chu S, Feng L, Zuo Y, Jing H, Zhang D, Tong Z, Shi J, Ma H, Zhang Z, Liang L. Evaluation of an innovative mHealth-based integrated modality for smoking cessation in Chinese smokers: protocol for a randomized controlled trial. BMC Public Health 2023; 23:561. [PMID: 36964513 PMCID: PMC10038776 DOI: 10.1186/s12889-023-15448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND AND AIMS Developing accessible, affordable, and effective approaches to smoking cessation is crucial for tobacco control. Mobile health (mHealth) based interventions have the potential to aid smokers in quitting, and integrating treatments from multiple sources may further enhance their accessibility and effectiveness. As part of our efforts in smoking cessation, we developed a novel behavioral intervention delivery modality for smoking cessation that integrated three interventions using the WeChat app, called the "Way to Quit" modality (WQ modality). It is presented here the protocol for a randomized controlled trial evaluating the effectiveness, feasibility, and cost-effectiveness of the WQ modality in Chinese smokers. METHODS Eligible participants (n = 460) will be recruited via online advertisement in Beijing, China. They will be randomly assigned to receive either quitline-based treatment (QT, n = 230) or WQ modality-based treatment (WQ, n = 230) using a block randomization method. Participants in the QT group will receive telephone-assisted treatment over a four-week period (multi-call quitline protocol), while those in the WQ group will receive integrated interventions based on the WQ modality for four weeks. A four-week supply of nicotine replacement therapy (gums) will be provided to all participants. Participants will be asked to complete phone or online follow-up at 1, 3, 6, and 12-months. At 1-month follow-up, individuals with self-reported smoking abstinence for more than 7 days will be invited to receive an exhaled carbon monoxide (CO) test for biochemical validation. The primary aim is to determine whether the WQ modality is effective in assisting smokers in quitting smoking. The secondary aims are to evaluate the acceptability, satisfaction, and cost-effectiveness of the WQ modality. DISCUSSION If the WQ modality is determined to be effective, acceptable, and affordable, it will be relatively easy to reach and provide professional cessation treatments to the communities, thus helping to reduce the disparities in smoking cessation services between different regions and socioeconomic groups. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2200066427, Registered December 5, 2022.
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Affiliation(s)
- Shuilian Chu
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Lin Feng
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Yingting Zuo
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Hang Jing
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Di Zhang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ju Shi
- School of Economics, Peking University, Beijing, China
| | - Haomiao Ma
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhijin Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lirong Liang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, No.8 Gong-Ti-Nan-Lu, Chaoyang District, Beijing, 100020, China.
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Chu S, Tong Z, Zhang Y, Ye X, Liu Z, Chen H, Bai J, Li F, Li X, Wang H, Wang R, Wang X, Li J, Liang S, Nong Y, Wang X, Wang A, Zhang D, Jing H, Feng L, Liang L. Usage, acceptability, and preliminary effectiveness of an mHealth-based integrated modality for smoking cessation interventions in Western China. Tob Induc Dis 2023; 21:07. [PMID: 36721862 PMCID: PMC9865639 DOI: 10.18332/tid/156828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Many smokers have not accessed professional smoking cessation assistance due to limited smoking cessation services. We developed a novel mHealth-based integrated modality for smoking cessation (WeChat + Quitline modality, WQ modality) and applied it to a large public welfare project (China Western-QUIT Program) in western China. This study evaluated the usage, acceptability, and preliminary effectiveness of the WQ modality in the population of western China. METHODS A prospective cohort study was conducted between April and August 2021. Smokers or their relatives were recruited through online advertisements and medical staff referrals. After using the services of the WQ modality for one month, the self-reported awareness, use, and satisfaction with each service among the participants were collected by a telephone interview. We also evaluated the self-reported 7-day point prevalence of abstinence (PPA) and quit attempt rate among baseline current smokers. The usage data of each service were downloaded from quitline and WeChat platforms. RESULTS Of the 17326 people from western China using the WQ modality, the largest number of users was WeChat official account (11173), followed by WeChat mini program (3734), WeChat group (669), and quitline (541 inbound calls, 605 outbound calls). At one month follow-up, over 70% of participants who completed the baseline survey (n=2221) were aware of WeChat-based services, and over 50% used them. However, the awareness rate (11.1%) and utilization rate (0.5%) of quitline were relatively low. The median satisfaction scores across all services were 9 out of 10 points (IQR: 8-9). Among the baseline current smokers (n=1257), self-reported 7-day PPA was 41.8% (526/1257), and another 225 smokers (17.9%) reported making a quit attempt. CONCLUSIONS The WQ modality could be well used and accepted, and it has great potential to motivate and aid short-term smoking cessation in smokers from western China.
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Affiliation(s)
- Shuilian Chu
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuntao Zhang
- Department of Respiratory Medicine, People’s Hospital of Lhasa Tibet, Lhasa, Tibet Autonomous Region, China
| | - Xianwei Ye
- Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Zhiyan Liu
- Department of Respiratory and Critical Care Medicine, Xi'an Third Hospital, Xi'an, China
| | - Hong Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jing Bai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Fengsen Li
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, China
| | - Xiaoping Li
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Zunyi, Zunyi, China
| | - Huaizhen Wang
- Hospital Management Office, Kashgar Prefecture Second People’s Hospital, Kashgar, China
| | - Rui Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuefeng Wang
- Department of Respiratory and Critical Care Medicine, Xining Second People’s Hospital, Xining, China
| | - Jiachen Li
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Siqiao Liang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ying Nong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xin Wang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, China
| | - Ahong Wang
- Department of Respiratory and Critical Care Medicine, Kashgar Prefecture Second People’s Hospital, Kashgar, China
| | - Di Zhang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hang Jing
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lin Feng
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lirong Liang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Portelli P, Bogolyubova O, Tristan Lopez B, Sainz-Maza A. A Quality Review of Smart-Phone Applications for Smoking Cessation. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2022. [DOI: 10.1080/15398285.2021.2021372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Pamela Portelli
- Department of Psychology, Faculty for Social Wellbeing, University of Malta, Msida, Malta
| | - Olga Bogolyubova
- Department of Psychology, Faculty for Social Wellbeing, University of Malta, Msida, Malta
| | - Belen Tristan Lopez
- Health and Clinical Psychology Department, Faculty of Psychology, University of Almeria, La Canaria, Almería, Espana
| | - Andrea Sainz-Maza
- Health and Clinical Psychology Department, Faculty of Psychology, University of Almeria, La Canaria, Almería, Espana
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Seo S, Cho SI, Yoon W, Lee CM. Classification of Smoking Cessation Apps: Quality Review and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e17268. [PMID: 35175213 PMCID: PMC8895289 DOI: 10.2196/17268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/05/2020] [Accepted: 12/02/2021] [Indexed: 01/26/2023] Open
Abstract
Background
Many people use apps for smoking cessation, and the effectiveness of these apps has been proven in several studies. However, no study has classified these apps and only few studies have analyzed the characteristics of these apps that influence their quality.
Objective
The purpose of this study was to analyze the content and the quality of smoking cessation apps by type and identify the characteristics that affect their overall quality.
Methods
Two app marketplaces (App Store and Google Play) were searched in January 2018, and the search was completed by May 2020. The search terms used were “stop smoking,” “quit smoking,” and “smoking cessation.” The apps were categorized into 3 types (combined, multifunctional, and informational). The tailored guideline of Clinical Practice Guideline for Treating Tobacco Use and Dependence was utilized for evaluating app content (or functions), and the Mobile App Rating Scale (MARS) was used to evaluate the quality. Chi-square test was performed for the general characteristics, and one-way analysis of variance was performed for MARS analysis. To identify the general features of the apps that could be associated with the MARS and content scores, multiple regression analysis was done. All analyses were performed using SAS software (ver. 9.3).
Results
Among 1543 apps, 104 apps met the selection criteria of this study. These 104 apps were categorized as combined type (n=44), functional type (n=31), or informational type (n=29). A large amount of content specified in the guideline was included in the apps, most notably in the combined type, followed by the multifunctional and informational type; the MARS scores followed the same order (3.64, 3.26, and 3.0, respectively). Regression analysis showed that the sector in which the developer was situated and the feedback channel with the developer had a significant impact on both the content and MARS scores. In addition, problematic apps such as those made by unknown developers or copied and single-function apps were shown to have a large market share.
Conclusions
This study is the first to evaluate the content and quality of smoking cessation apps by classification. The combined type had higher-quality content and functionality than other app types. The app developer type and feedback channel with the app developer had a significant impact on the overall quality of the apps. In addition, problematic apps and single-function apps were shown to have a large market share. Our results will contribute to the use and development of better smoking cessation apps after considering the problems identified in this study.
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Affiliation(s)
- Suin Seo
- Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Sung-Il Cho
- Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Wonjeong Yoon
- Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
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Bricker JB, McAfee T. Smartphone applications for intervening on addictive behaviors: efficacy is just one phase of the marathon. Addiction 2021; 116:3284-3285. [PMID: 34184335 PMCID: PMC8578285 DOI: 10.1111/add.15608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Jonathan B. Bricker
- Division of Public Sciences, Fred Hutchinson Cancer
Research Center, Seattle, Washington, United States
- Department of Psychology, University of Washington,
Seattle, Washington, United States
| | - Tim McAfee
- Department of Health Services, University of Washington,
Seattle, Washington, United States
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Barroso-Hurtado M, Suárez-Castro D, Martínez-Vispo C, Becoña E, López-Durán A. Smoking Cessation Apps: A Systematic Review of Format, Outcomes, and Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111664. [PMID: 34770178 PMCID: PMC8583115 DOI: 10.3390/ijerph182111664] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022]
Abstract
Smoking cessation interventions are effective, but they are not easily accessible for all treatment-seeking smokers. Mobile health (mHealth) apps have been used in recent years to overcome some of these limitations. Smoking cessation apps can be used in combination with a face-to-face intervention (FFSC-Apps), or alone as general apps (GSC-Apps). The aims of this review were (1) to examine the effects of FFSC-Apps and GSC-Apps on abstinence, tobacco use, and relapse rates; and (2) to describe their features. A systematic review was conducted following the internationally Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of the total 6016 studies screened, 24 were included, of which nine used GSC-Apps and 15 FFSC-Apps. Eight studies reported significant differences between conditions in smoking cessation outcomes, with three of them being in favor of the use of apps, and two between different point-assessments. Concerning Apps features, most GSC-Apps included self-tracking and setting a quit plan, whereas most of the FFSC-Apps included self-tracking and carbon monoxide (CO) measures. Smartphone apps for smoking cessation could be promising tools. However, more research with an adequate methodological quality is needed to determine its effect. Nevertheless, smartphone apps’ high availability and attractiveness represent a great opportunity to reach large populations.
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Affiliation(s)
- María Barroso-Hurtado
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Correspondence: ; Tel.: +34-881-81-39-39
| | - Daniel Suárez-Castro
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Ana López-Durán
- Smoking and Addictive Disorders Unit, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (D.S.-C.); (C.M.-V.); (E.B.); (A.L.-D.)
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Liao Y, Tang J. Efficacy of cognitive behavioural therapy-based smartphone app for smoking cessation in China: a study protocol of a randomised controlled trial. BMJ Open 2021; 11:e041985. [PMID: 33441359 PMCID: PMC7812100 DOI: 10.1136/bmjopen-2020-041985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION A number of smartphone apps have been proved to be effective in assisting smoking cessation in many countries, but little is known about the effectiveness of smartphone apps that assist in smoking cessation in China. This study aims to evaluate the efficacy of cognitive behavioural therapy (CBT)-based cigarette smoking cessation smartphone app for treatment-seeking smokers in China. METHODS AND ANALYSIS In this remote control, randomised controlled trial, the participants will be randomised and allocated in 1:1 ratio to smoking cessation app intervention group or to control group. Participants will receive a 12-week intervention (treatment group will receive CBT-based cigarette smoking cessation smartphone app intervention and control group will receive text messaging-based control intervention) with follow-up at week 26. The primary outcome includes biologically verified continuous smoking abstinence at week 26 after the quit date. The main secondary outcomes include 7-hour point prevalence smoking abstinence at weeks 1, 2, 3, 4, 8, 12, 16, 20 and 26, self-reported continuous smoking abstinence at weeks 4, 8, 12, 16, 20 and 26 after the quit date. About 1200 smokers with willingness to make a quit attempt within a month from January 2021 to August 2021 or until the recruitment process is complete will be recruited. The final 26-week follow-up will be completed in August 2022. The trial results will be available by the end of 2022. All analyses will be done on an intention-to-treat basis. Based on the previous studies, we hypothesised that this CBT-based app will be an effective, feasible and accessible smoking cessation app in China. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics committee of Sir Run Run Shaw Hospital, an affiliate of Zhejiang University, Medical College (number: 20200129-33). Study results will be disseminated via research conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04421170.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
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Liao Y, Tang J. Feasibility and Acceptability of a Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: A Single-Group Cohort Study. Front Psychiatry 2021; 12:759896. [PMID: 35309757 PMCID: PMC8928122 DOI: 10.3389/fpsyt.2021.759896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous research has suggested that mobile phone applications (apps) may potentially increase quit rates. The purpose of this single-group cohort study sought to examine the feasibility and acceptability of a novel smartphone-based smoking cessation app designed for smoking cessation in China: smoking quit rate. METHODS A total of 180 smokers from two cities of mainland China with willingness to make a quit attempt were invited to this smoking cessation app program, a cognitive behavioral theory (CBT)-based smoking cessation intervention via a smartphone app. Participants received 37- to 44-day intervention (including 7- to 14-day pre-quit preparation and 33-day intervention from quit date). Feasibility and acceptability of the program, and smoking status were assessed at baseline stage (initial installation), pre-quit stage, and post-quit stage (days 7, 15, and 33 after quit date). RESULTS A total of 163 (90.6%) participants completed the study. Among them, 76-89% of the participants logged into the app ≥1 time per day across stages (at baseline, during pre-quit stage, and on days 7, 15, and 33 of post-quit stage); approximately 90% of the participants were satisfied with the app across stages. A significant rise in self-reported overall satisfaction with the app is observed from baseline (93% at Time 1) to the end of the program (98% at Time 2, 33 days after quit date) (p = 0.021). Participants who believed/agreed this app can help them to quit smoking significantly increased from 69% at baseline to 97% at day 33 after quit date (p < 0.001). Participants were satisfied with most (80-90%) of the features, especially the information feature. Intention-to-treat analysis showed that the percentage of 33-day self-reported continuous prevalence abstinence was 63.9%, and 7-day point prevalence abstinence rate was 81.7, 87.2, and 77.8% on days 7, 15, and 33 after quit date, respectively. CONCLUSIONS This study demonstrated the feasibility and acceptability of the smartphone app intervention for smoking cessation and introduced a new digital treatment model, which is expected to overcome barriers facing accessing traditional in-person smoking cessation services and extend nationwide smoking cessation services in China.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
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Chen J, Ho E, Jiang Y, Whittaker R, Yang T, Bullen C. Mobile Social Network-Based Smoking Cessation Intervention for Chinese Male Smokers: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e17522. [PMID: 33095184 PMCID: PMC7647814 DOI: 10.2196/17522] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/04/2020] [Accepted: 07/07/2020] [Indexed: 01/19/2023] Open
Abstract
Background Around 2 million Chinese people, mostly men, die annually from tobacco-related diseases; yet, fewer than 8% of Chinese smokers ever receive any smoking cessation support. Objective This study aimed to test the preliminary effectiveness and feasibility for a mobile social network (WeChat)–based smoking cessation intervention (SCAMPI program) among Chinese male smokers. Methods Chinese male smokers aged 25-44 years were recruited online from WeChat, the most widely used social media platform in China. Individuals using other smoking cessation interventions or who lacked capacity to provide online informed consent were excluded. Participants were randomly assigned (1:1) to intervention or control groups. Neither participants nor researchers were masked to assignment. The trial was fully online. All data were collected via WeChat. The intervention group received access to the full-version SCAMPI program, a Chinese-language smoking cessation program based on the Behaviour Change Wheel framework and relevant cessation guidelines. Specific intervention functions used in the program include: planning to help users make quitting plans, calculator to record quitting benefits, calendar to record progress, gamification to facilitate quitting, information about smoking harms, motivational messages to help users overcome urges, standardized tests for users to assess their levels of nicotine dependence and lung health, as well as a social platform to encourage social support between users. The control group had access to a static WeChat page of contacts for standard smoking cessation care. Both groups received incentive credit payments for participating. The primary outcome was 30-day biochemically verified smoking abstinence at 6 weeks after randomization, with missing data treated as not quitting. Secondary outcomes were other smoking status measures, reduction of cigarette consumption, study feasibility (recruitment and retention rate), and acceptability of and satisfaction with the program. Results The program recorded 5736 visitors over a 13-day recruitment period. We recruited 80 participants who were randomly allocated to two arms (n=40 per arm). At 6 weeks, 36 of 40 (90%) intervention participants and 35 of 40 (88%) control participants provided complete self-reported data on their daily smoking status via WeChat. Biochemically verified smoking abstinence at 6 weeks was determined for 10 of 40 (25%) intervention participants and 2 of 40 (5%) control participants (RR=5, 95% CI 1.2-21.4, P=.03). In the intervention group, the calculator function, motivational messages, and health tests were underused (less than once per week per users). Participants rated their satisfaction with the intervention program as 4.56 out of 5.00. Conclusions Our program is a novel, accessible, and acceptable smoking cessation intervention for Chinese male smokers. A future trial with a greater sample size and longer follow-up will identify if it is as effective as these preliminary data suggest. Trial Registration ANZCTR registry, ACTRN12618001089224; https://tinyurl.com/y536n7sx International Registered Report Identifier (IRRID) RR2-18071
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Affiliation(s)
- Jinsong Chen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Elsie Ho
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Tingzhong Yang
- Centre for Tobacco Control Research, Zhejiang University, Hangzhou, China
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
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Zhang H, Wang T, Zhang Z, Lin B, Mei Y, Zhang Y, Chen G. The current status of stroke-related smartphone applications available to adopt in China: A systematic review study. Medicine (Baltimore) 2020; 99:e20656. [PMID: 32629637 PMCID: PMC7337469 DOI: 10.1097/md.0000000000020656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Stroke-related smartphone applications (apps) present enormous potential for stroke management as apps become increasingly prevalent in China. However, there is no comprehensive study reported about the currents status of stroke-related apps available to adopt in Chinese app market. The aim of this study is to assess the current status of stroke-related apps available to adopt in China. MATERIALS AND METHODS Using Stroke-related keywords written in either Chinese or English, the top 6 most prevalent apps online stores in China were searched from June to August 2018, including android market, 360 app market, wan dou jia, baidu mobile app, ying yong bao, apple app store. The basic features of selected apps were analyzed based on operating system, cost, target people, engagement, online interaction, release date, size, popularity, and usefulness. The information accountability of selected apps was evaluated with the Silberg scale. The functionality of selected apps targeting stroke patients at home were reviewed by researchers. RESULTS Our study showed that the downloads of stroke-related apps from android platform and the engagement of health professionals in apps development were critically insufficient. And most apps didn't offer a platform to facilitate online interaction with health professional. The information accountability of apps also presented a huge room for improvement. The average Silberg score of 127 apps was 3.5 (out of 9) with most apps not disclosing sponsorship, authors' affiliations, credentials, and sources or references of information. Few apps were modified in the past months. What's more, although the apps targeting stroke patients at home have covered 9 functionalities, most apps had only a simple functionality. CONCLUSION This study identified areas for improvement concerning information accountability of stroke-related apps available for adoption in China and reviewed functionality of apps targeting stroke patients at home. The findings might guide the development for stroke-related apps in China in the future.
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Affiliation(s)
- Huixia Zhang
- The First Affiliated Hospital of Henan University of Chinese Medicine
- School of Nursing, Zhengzhou University
| | - Tao Wang
- School of Nursing, Zhengzhou University
| | | | | | | | | | - Gang Chen
- Industrial Technology Research Institute, Zhengzhou, China
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15
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Gong E, Zhang Z, Jin X, Liu Y, Zhong L, Wu Y, Zhong X, Yan LL, Oldenburg B. Quality, Functionality, and Features of Chinese Mobile Apps for Diabetes Self-Management: Systematic Search and Evaluation of Mobile Apps. JMIR Mhealth Uhealth 2020; 8:e14836. [PMID: 32255432 PMCID: PMC7175187 DOI: 10.2196/14836] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/18/2019] [Accepted: 12/15/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The emergence and advancement of mobile technologies offer a promising opportunity for people with diabetes to improve their self-management. Despite the proliferation of mobile apps, few studies have evaluated the apps that are available to the millions of people with diabetes in China. OBJECTIVE This study aimed to conduct a systematic search of Chinese mobile apps for diabetes self-management and to evaluate their quality, functionality, and features by using validated rating scales. METHODS A systematic search was conducted to identify Chinese apps for diabetes self-management in the four most popular Chinese language mobile app stores. Apps were included if they were designed for diabetes self-management and contained at least one of the following components: blood glucose management, dietary and physical activity management, medication taking, and prevention of diabetes-related comorbidities. Apps were excluded if they were unrelated to health, not in Chinese, or the targeted users are health care professionals. Apps meeting the identified inclusion criteria were downloaded and evaluated by a team of 5 raters. The quality, functionalities, and features of these apps were assessed by using the Mobile App Rating Scale (MARS), the IMS Institute for Healthcare Informatics Functionality score, and a checklist of self-management activities developed based on the Chinese diabetes self-management guideline, respectively. RESULTS Among 2072 apps searched, 199 were eligible based on the inclusion criteria, and 67 apps were successfully downloaded for rating. These 67 apps had an average MARS score of 3.42 out of 5, and 76% (51/67) of the apps achieved an acceptable quality (MARS score >3.0). The scores for the four subdomains of MARS were 3.97 for functionality, 3.45 for aesthetics, 3.21 for information, and 3.07 for engagement. On average, reviewed apps applied five out of the 19 examined behavior change techniques, whereas the average score on the subjective quality for the potential impact on behavior change is 3 out of 5. In addition, the average score on IMS functionality was 6 out of 11. Functionalities in collecting, recording, and displaying data were mostly presented in the reviewed apps. Most of the apps were multifeatured with monitoring blood glucose and tracking lifestyle behaviors as common features, but some key self-management activities recommended by clinical guidelines, such as stress and emotional management, were rarely presented in these apps. CONCLUSIONS The general quality of the reviewed apps for diabetes self-management is suboptimal, although the potential for improvement is significant. More attention needs to be paid to the engagement and information quality of these apps through co-design with researchers, public health practitioners, and consumers. There is also a need to promote the awareness of the public on the benefit and potential risks of utilizing health apps for self-management.
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Affiliation(s)
- Enying Gong
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Zongmuyu Zhang
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Medicine, Tsinghua University, Beijing, China
| | - Xurui Jin
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Yishan Liu
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
- College of Science and Engineering, University of Edinburgh, Edinburgh, United Kingdom
| | - Lumin Zhong
- School of Public Health, Shanghai Jiaotong University, Shanghai, China
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Yao Wu
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Engineering, University of Melbourne, Melbourne, Australia
| | - Xuefeng Zhong
- Department of Personal Health, Philips Research China, Shanghai, China
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Assessing Digital Support for Smoking Cessation. INFORM SYST 2020. [DOI: 10.1007/978-3-030-44322-1_25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Xu J, Bricker J, Fu X, Su C, Wang P, Qi T, Cheng F. Design and Development of Smoking Cessation Apps Based on Smokers' and Providers' Perspectives in China: Survey Study. JMIR Mhealth Uhealth 2019; 7:e12200. [PMID: 31588914 PMCID: PMC6800458 DOI: 10.2196/12200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 06/06/2019] [Accepted: 07/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although there are more than 60 smartphone apps for smoking cessation in China, many of them do not include the content and features that health care professionals and smokers prefer-which may make them impractical, unengaging, and ineffective. Therefore, we investigated both health care providers' and smokers' preferences for features of future smoking cessation apps. OBJECTIVE This study aimed to investigate Chinese health care providers' and smokers' desired features of a smoking cessation app, with the goal of providing design recommendations for app designers and researchers. METHODS Both Chinese smokers who own smartphones (n=357) and Chinese health care providers (n=224) responded to a survey collecting data on their sociodemographic characteristics and opinions on the importance of 20 smoking cessation app design features studied in previous US research. RESULTS Chinese health care providers expressed strong support of smoking cessation apps on a number of attitude indicators (range 153/224, 68.3% to 204/224, 91.1%). They rated nearly all (18/20) features as very or extremely important (range 52.2%-83.4%) and rated nearly all features (17/20) as more important than the smokers did. More than 60% of smokers rated the following 4 features as very or extremely important: allow sharing the process of smoking cessation with family members and friends (216/319, 67.7%), helping smokers track their progress (such as the amount of smoking per day; 213/319, 66.8%), helping with the side effects of medications and nicotine withdrawal symptoms (201/319, 63.0%), and adapting to ongoing needs and interests of smokers (194/319, 60.8%). Contrary to a similar study of US smokers and health care providers, Chinese smokers and providers rated reputation and ability to communicate with family members and friends as important features, whereas Chinese smokers rated privacy and security as less important. CONCLUSIONS The design of future smoking cessation and health behavior change apps should consider perspectives of both providers and smokers as well as the role of culture.
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Affiliation(s)
- Junfang Xu
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jonathan Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Xiaoxing Fu
- Institute of Anthropology, Renmin University of China, Beijing, China
| | - Chunyan Su
- Media School, University of Chinese Academy of Social Sciences, Beijing, China
| | - Peicheng Wang
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Tengfei Qi
- Department of Sociology, Tsinghua University, Beijing, China
| | - Feng Cheng
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China
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Abstract
China is in the midst of a lung cancer epidemic on an unprecedented scale. In 2015, there were an estimated 733,000 new lung cancer cases (17% of total cancer incidence) and 610,000 deaths (21.7% of total cancer mortality) in China. Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality in China. Tobacco smoke exposure is the primary factor driving current lung cancer trends. In 2015, smoking prevalence was 27.7% (52.1% among men and 2.7% among women). China has taken substantial steps to control tobacco use in recent years, including 19 cities implementing comprehensive smoke free laws and expansion of cessation services. However, significant challenges remain in order to meet the 2030 Healthy China goal of reducing smoking prevalence to 20%. In particular, ongoing attention is needed to continuing to control secondhand smoke exposure, to further enhance smoking cessation services, and to address novel alternative nicotine delivery devices (ANDS).
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Affiliation(s)
- Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, MD, USA
| | - Lin Xiao
- Center for Disease Control and Prevention, Beijing 102206, China
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Abstract
AbstractAimsTo evaluate the quality and content of free smoking cessation apps and assess their adherence to the US Public Health Service guideline for treating tobacco use and dependence.MethodsIn total 180 apps were downloaded from the App Store and Google Play Store in January 2018; the top-ranking 30 apps were retrieved for the search terms: ‘smoking cessation’, ‘quit smoking’, ‘stop smoking’. Technical quality was rated using the Mobile Application Rating Scale (MARS) and by assessing other characteristics, behavioral change strategies and adherence to the 5As.Results/findingsA total 67 free-to-download apps were identified for full review (n = 40 from the Apple App Store and n = 27 from the Google Play Store). The average MARS score was 16.2/19.0: Engagement (3.3/5.0), Functionality (4.4/5.0), Aesthetics (4.0/5.0), and Information (2.6/5.0). Overall, 43 apps allowed sharing, 12 allowed for an app community, and five required a password. The following features were observed: assessment (n = 51), feedback (n = 38), information/education (n = 45), monitoring (n = 52), and goal setting (n = 23). Significant differences were found among apps adhering to the 5As: Ask (n = 44), Advise (n = 54), Assess (n = 30), Assist (n = 62), and Arrange (n = 0).ConclusionsGiven the growth in smoking cessation apps, future efforts should focus on improving their technical quality and adherence to the 5As.
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A Face-Aging Smoking Prevention/Cessation Intervention for Nursery School Students in Germany: An Appearance-Focused Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081656. [PMID: 30081549 PMCID: PMC6121507 DOI: 10.3390/ijerph15081656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/24/2018] [Accepted: 08/02/2018] [Indexed: 12/27/2022]
Abstract
The Education Against Tobacco (EAT) network delivers smoking prevention advice in secondary schools, typically using the mirroring approach (i.e., a “selfie” altered with a face-aging app and shared with a class). In November 2017, however, the German assembly of EAT opted to expand its remit to include nursing students. To assess the transferability of the existing approach, we implemented it with the self-developed face-aging app “Smokerface” (=mixed − methods approach) in six nursing schools. Anonymous questionnaires were used to assess the perceptions of 197 students (age 18–40 years; 83.8% female; 26.4% smokers; 23.3% daily smokers) collecting qualitative and quantitative data for our cross-sectional study. Most students perceived the intervention to be fun (73.3%), but a minority disagreed that their own animated selfie (25.9%) or the reaction of their peers (29.5%) had motivated them to stop smoking. The impact on motivation not to smoke was considerably lower than experienced with seventh graders (63.2% vs. 42.0%; notably, more smokers also disagreed (45.1%) than agreed (23.5%) with this statement. Agreement rates on the motivation not to smoke item were higher in females than in males and in year 2–3 than in year 1 students. Potential improvements included greater focus on pathology (29%) and discussing external factors (26%). Overall, the intervention seemed to be appealing for nursing students.
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Bernardes-Souza B, Patruz Ananias De Assis Pires F, Madeira GM, Felício Da Cunha Rodrigues T, Gatzka M, Heppt MV, Omlor AJ, Enk AH, Groneberg DA, Seeger W, von Kalle C, Berking C, Corrêa PCRP, Suhre JL, Alfitian J, Assis A, Brinker TJ. Facial-Aging Mobile Apps for Smoking Prevention in Secondary Schools in Brazil: Appearance-Focused Interventional Study. JMIR Public Health Surveill 2018; 4:e10234. [PMID: 30021713 PMCID: PMC6068381 DOI: 10.2196/10234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/03/2018] [Accepted: 05/29/2018] [Indexed: 01/19/2023] Open
Abstract
Background Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. Objective In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. Methods We used a free facial-aging mobile phone app (“Smokerface”) in three Brazilian secondary schools via a novel method called mirroring. The students’ altered three-dimensional selfies on mobile phones or tablets and images were “mirrored” via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. Results The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. Conclusions Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.
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Affiliation(s)
| | | | | | | | - Martina Gatzka
- University of Ulm, Department of Dermatology and Allergic Diseases, Ulm, Germany
| | - Markus V Heppt
- University Medical Center Munich, Department of Dermatology and Allergology, Munich, Germany
| | - Albert J Omlor
- Saarland University Medical Center, Department of Experimental Pneumology and Allergology, Saarland University, Homburg, Germany
| | - Alexander H Enk
- Heidelberg University Hospital, Department of Dermatology, University of Heidelberg, Heidelberg, Germany, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University of Frankfurt, Frankfurt, Germany
| | - Werner Seeger
- Excellence Cluster Cardiopulmonary System, University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Justus-Liebig-University, Gießen, Germany
| | - Christof von Kalle
- National Center for Tumor Diseases (NCT), Department of Translational Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Carola Berking
- University Medical Center Munich, Department of Dermatology and Allergology, Munich, Germany
| | | | - Janina Leonie Suhre
- University Hospital of Bonn, Department of Pulmonary Medicine, University of Bonn, Bonn, Germany
| | - Jonas Alfitian
- University Hospital of Cologne, Department of Cardiology, University of Cologne, Cologne, Germany
| | - Aisllan Assis
- School of Medicine, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Titus Josef Brinker
- Heidelberg University Hospital, Department of Dermatology, University of Heidelberg, Heidelberg, Germany, Germany.,National Center for Tumor Diseases (NCT), Department of Translational Oncology, German Cancer Research Center, Heidelberg, Germany.,German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
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