JMIR Publications

ABSTRACT

Background:

The majority of cigarette smokers want to quit someday but are not ready to commit to long-term abstinence. Available treatments are not well-suited to meet the needs of these smokers. Low-cost, high-reach mobile health (mHealth) interventions offer a cost-efficient means of offering assistance to ambivalent smokers, yet there are currently no evidence-based options available for this group.

Objective:

To develop and preliminarily evaluate the core content for an mHealth program targeting adult smokers who are ambivalent about quitting. The core content consisted of a series of “personal experiments”—i.e., brief cognitive or behavioral tasks designed to boost readiness for changing smoking behavior.

Methods:

We conducted individual user interviews (n=3) to refine program content, then conducted a pilot study (n=25) to assess user receptivity and potential impact of the experiments on motivation and self-efficacy to quit or reduce smoking.

Results:

In user interviews, participants liked the concept of the personal experiments. Participants in the pilot study found a medium-fidelity prototype highly acceptable. After watching a brief orientation video that explained how the program works, most participants (80%, 20/25) indicated that it sounded interesting, primarily because it did not require a commitment to quit. 100% (25/25) completed all 7 experiments, including a 24-hour quit attempt, although not all were able to stay quit for a full day. The mean rating of usefulness of the overall program was 4.12 (SD=1.09) out of 5, and the average rating of the difficulty of the experiments was 2.16 (SD=1.18) out of 5. At the last assessment point, 92% (23/25) told us that they were more interested in either quitting or cutting back than when they began the program, and 72% (18/25) said if the program had included a free trial of nicotine replacement therapy (NRT), they would have used it to try to quit smoking.

Conclusions:

This formative work confirmed that ambivalent smokers are willing to use and will remain engaged with an mHealth intervention that employs the novel concept of personal experiments to enhance their motivation for and ability to quit smoking. The addition of action-oriented treatment (self-help and NRT, quitline referral) could further support users’ efforts to stop smoking and remain quit.