Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 5, 2020
Date Accepted: Aug 2, 2021
Use of a smartphone self-assessment application for tobacco-induced diseases (COPD, cardiovascular diseases, cancer) screening strategy and to encourage smoking cessation.
ABSTRACT
Background:
Patient monitoring via mobile application detects actionable symptoms and has been shown to detect lung cancer relapses early, thereby lengthening survival.
Objective:
The purpose of this study was to assess the incidence of chief symptoms associated with the main tobacco-induced pathologies on both current and ex-smokers through a self-assessment smartphone application, and to evaluate its capacity to incite users to quit smoking or reduce consumption, as well as its impact on lung cancer stages at the time of diagnosis.
Methods:
Current and ex-smokers were recruited through an advertising campaign in the Sarthe département (France) proposing the free download of a smartphone application. Application users were asked to answer 13 questions related to symptoms associated with tobacco-induced diseases (COPD, cardiovascular diseases, cancer). In the event of any positive answer, a message was displayed recommending to consult a physician. Besides, they were asked about smoking cessation intention before and after answering these 13 questions. Finally, incidence of stage 1 and 2 lung cancer diagnosed during the spreading period was evaluated by comparing data from various sources to those from the same period during the previous year.
Results:
5671 users were eligible for evaluation. An alert was sent to a majority of users (73%), with a higher incidence on current smokers (77% vs 65%, p<0,001). The most frequent symptoms triggering the notifications were fatigue (36%), cough (29%), dyspnea (26%) and persistent chest pain (23%). 14% of the current smokers showed symptoms suggesting COPD, 16% suggesting stable angina, 12% were probably suffering from LEAD and 7% from possible cancer. 37% of the users claimed thinking about quitting smoking and 49% about reducing their consumption. Surgery-eligible stage 1 and 2 lung cancer incidence was 24% versus 9% during the previous year (p=0,04) in the Sarthe département whereas it remained unchanged in the neighboring département of Maine-et-Loire.
Conclusions:
A majority of current and ex-smokers show worrying symptoms and the use of a self-monitoring smartphone application drives a majority of smokers towards intentions of smoking cessation or consumption decrease. The dissemination of the application seems to increase symptomatic lung cancer detection at early, surgery-accessible stages. Clinical Trial: clinicaltrials.gov Identifier: NCT04048954
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