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App to motivate young smokers to quit

Updated: Apr 29, 2021

Literature Review by Will Remigio



Research

Article Title: Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers. McClure, E. A., Tomko, R. L., Carpenter, M. J., Treiber, F. A., & Gray, K. M. (2018). Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers. The American Journal of Drug and Alcohol Abuse, 44 (5), 561-570.



Research Purpose/Question(s)

#MyMobileMonitor (#M3) is a smartphone app developed to identify traces of carbon monoxide (CO) in the breath of youth. The app was used as an inexpensive method to monitor and help youth quit smoking cigarettes. This study, however, focuses on the compliance, feasibility, acceptability, and validity of the M3 app in successfully helping users quit smoking.


Sample/ Audience

Participants had to meet the following criteria: Must be between 15 – 25 years old; smoking more than five cigarettes per day for at least 3 months; willing to stop using tobacco and marijuana during the study; free of any unstable health or psychiatric disorders which could interfere with the study; not pregnant; and not urgently seeking smoking cessation. Sixty there youth were referred; only 32 scheduled a follow up, but only 23 qualified. Two participants dropped out due to time constraints. 16 young adults (average age 22.3) (75% female) (88% White and 12% African American) completed the study. The majority of participants had a high school diploma or completed some college.


Methods


Research with minors was approved by the Institutional Review Board (IRB), although this was not necessary as consent was not received by participant under the age of 18. Participants were recruited via online advertisements or referred by friends or from previous studies.


M3 Session Procedures


The #M3app was only available through #IOS (iPhones); seven our of the 16 participants had android phones, therefore iPhones were loaned for participant-use during the eleven day study. The first day was structured by research staff providing informed consent followed by participants attending a training visit on how to use the M3 mobile app. The 11 day study was structured in three parts. Two days of #regularsmoking and self-testing of CO breath levels. Followed by 2 days of quit-attempts. Followed by 7 days of #abstinencemonitoring. Ecological Measurement Assessments (#EMA) were used to measure compliance, feasibility and acceptability of the M3 app, abstinence rates, and adherence to smoking cessation goals. Participants used their smartphones in real-time to answer multiple EMA survey questions on a daily basis. On day three and four participants were paid $5 for each (four abstinent samples per day) measures without CO levels. Compensation for abstinent samples ceased when monitoring began on day 5 (abstinence monitoring part).


Participants were vetted for initial qualification into the study, assessed for smoking cessation progress outcomes during the study, and assessed the acceptability of the M3 app using several empirical measurements. #EMA questions were adopted from a previous smoking cessation study. The EMA asked questions regarding cravings, social context, recent consumption behaviors, and time since last cigarette.



Results


The study resulted in an overall 69% compliance rate (compliance to the M3 remote sessions). Higher compliance rates (76%) occurred when youth could continue sessions despite having had under reported the number of cigarette intake. Continuous smoking occurred in 31% of participants with no reports of abstinence. 40% of participants reported having relapsed after the quit smoking period (day 4). One participant did not report smoking until day 9, but consistent CO levels were observed in their reports.



Strengths of Study


Allowing remote participation may have resulted in more reliable responses, free from scientific environmental cues which may affect participant responses.



Limitations of Study


Limitations to this study included not allowing participants to use their own #cellphones due to the M3 app available for #iPhones only; the recruitment of participants not ready to quit #smoking; bulky CO equipment; and strict procedures (45 mins to respond to surveys questions).



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