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Digital Technologies Gain Popularity for Smoking Cessation: Evidence Strongly Supports Some
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Digital Technologies Gain Popularity for Smoking Cessation: Evidence Strongly Supports Some

Milly Dawson, MS, MPH
It’s a 4-month program planned around a person’s quit date, with tracking for a total of 9 months. “It’s a multimedia program that combines text, Web, e-mail and mobile webs, with text playing a key role,” says CEO Justin Sims. Users find mobile web pages in the texts for more information on specific topics. Alere Inc has licensed Voxiva’s Text2Quit program and integrated it into their telephone- and Web-based smoking cessation services. Alere handles the quitlines for 32 states. “When individuals dial a quitline in many states, they are offered Text2Quit there and then,” says Sims. When a person uses Text2Quit, information they text back enters a file, and is also seen by human coaches. People needing human interaction receive it.

With regard to all the new digital approaches, Berger sounds 1 cautionary note, warning that privacy laws and regulations “remain poorly articulated.” She points to a notable “lack of clarity”

regarding the degree of privacy that must be afforded to personal health information exchanged digitally, such as through text messages.

Where the FDA Stands

In an e-mail response, Jenny Haliski at FDA Office of Media Affairs said that the FDA does not comment on specific products or whether a particular product requires their review. Still, based on content on the FDA website, smoking cessation text programs and apps do not seem to require FDA approval, because they are neither intended for use as accessories to regulated medical devices nor do they transform a mobile platform into a regulated medical device. The FDA encourages app developers to contact the FDA as early as possible with any questions about their mobile app, its level of risk, or whether a premarket application is required.9

Free Digital Tools Available to Consumers

The US government has interactive text messaging tools available free of charge at several websites, including www.smokefree.gov, www.women.smokefree.gov, and www.teen.smokefree.gov. These sites also provide smokers with no-cost apps such as QuitSTART App, which is available for iOS and Android. The sites now provide brief information on Quit-Pal, the app described above, which is now  under development at the NCI and scheduled for availability in a few weeks.

Healthcare providers whose patients may be spending money on commercially available apps with no research basis behind them may want to steer those patients to the free apps offered by the government that were created with proven methods in mind.

References

1. Centers for Disease Control and Prevention. http://teen.smokefree.gov/. Accessed December 2013.

2. Centers for Disease Control and Prevention. Adult cigarette smoking in the United States: current estimates. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. Accessed November 7, 2013.

3. Centers for Disease Control and Prevention. Fast facts. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/. Accessed November 7, 2013.

4. Whittaker R, McRobbie H, Bullen C, Borland R, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. The Cochrane Library. http://onlinelibrary.wiley.com/
doi/10.1002/14651858.CD006611.pub3/abstract. Published 2012. Accessed November 6, 2013.

5. Abroms L, Padmanabhan N, Thaweethal L, Phillips T. iPhone apps for smoking cessation: a content analysis. Am J Prev Med. 2011;40(3):279-285.

6. Massett H, Atkinson N, Kraiger A, Grady M, Killam B, Barry B. NCI quitpal: an evidence based app to help people quit smoking. The 2013 Annual Meeting of the American Public Health Association. https://apha.confex.com/apha/141am/webprogram/Paper284220.html. Accessed November 12, 2013.

7. Vadivieso-Lopez E, Flores-Mateo G, Molina-Gomez J-D, et al. Efficacy of a mobile application for smoking cessation in young people: study protocol for a clustered, randomized trial. BMC Public Health. 2013,13:704.

8. Free C, Knight R, Robertson S, et al. Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial. Lancet. 2011;378(9785):49-55.

9. US Food and Drug Administration. Mobile devices. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/default.htm. Accessed
February 18, 2014.
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