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Frequent Smokers Ambivalent About Quitting May Be More Receptive to Tailored Interventions


This small study showed that individuals who used an app designed specifically for smokers ambivalent about quitting used the app more often and exhibited greater changes in behavior compared with those using a similar nontailored app.

Frequent smokers who are unsure about quitting may be receptive to a tailored app on their phone, suggests a new pilot study published in JMIR mHelath and uHealth.

The small study of 57 participants showed that individuals who used a novel app designed specifically for smokers ambivalent about quitting used the app more often and exhibited greater changes in behavior compared with those using a similar app that was not specifically tailored to them.

People participating in the study included those typically less likely to engage in smoking cessation practices, including those who were of lower socioeconomic status and smoked heavily.

“Taken together, these findings confirm the conclusions drawn from our previous formative work that smokers who are ambivalent about quitting, including those who are more socioeconomically disadvantaged, are interested in using a [mobile health] app to help them reduce or stop smoking and that designing this intervention to be sensitive to participants’ ambivalence about quitting could increase their likelihood of changing their smoking behavior,” wrote the researchers of the study.

Participants included in the study smoked more than 10 cigarettes a day. Each participant was randomly assigned to use either the standard care version of the app or the enhanced care version. Both versions of the app offered evidence-based smoking cessation advice and resources. The latter version also included various self-directed exercises aimed to help users resist the urge to smoke and to motivate them to attempt to quit smoking, including an exercise directing the user to identify personal reasons for quitting smoking. This enhanced version of the app also included reminders to begin or complete these exercises.

multitasking in hands: © Romolo Tavani - stock.adobe.com

multitasking in hands: © Romolo Tavani - stock.adobe.com

Participants using the enhanced version of the app used their app more often than participants using the standard app (19.9 vs 7.3 sessions), which correlated with higher cessation rates. At 3 months, nearly 15% of patients using the enhanced app reported smoking abstinence vs approximately 7% of participants using the standard app.

Across both groups, more than one-third of participants reported attempting to quit smoking, including 39.3% using the enhanced app and 37.9% using the standard app. Across the entire patient cohort, satisfaction with the apps was high, with participants giving the apps a mean 4.1 rating out of 5 on the Likert scale. There were 43 participants who provided insight on their willingness to recommend the app, 41 of whom said they would recommend their version of the app to other smokers.

Although 57 participants installed and used the app, 60 originally consented to and enrolled in the study, noted the researchers.

“It is encouraging that 95% of the participants who agreed to enroll in the study installed the app. This provides an important initial signal of the intervention’s acceptability,” explained the group. “However, because of the size and nature of the study, conclusions about the acceptability and impact of the intervention among participants who installed the app cannot be based on the statistical significance of the primary and secondary outcome comparisons. Instead, it is important to look at the trend and pattern of the point estimates at follow-up. Notably, in almost all cases, the observed outcomes trended in favor of the enhanced care app version.”


McClure J, Heffner J, Krakauer C, Mun S, Klasnja P, Catz S. Feasibility, acceptability, and potential impact of a novel mHealth app for smokers ambivalent about quitting: randomized pilot study. JMIR mhealth uhealth. Published online June 28, 2023. doi:10.2196/46155

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