JMIR Publications

ABSTRACT

Background:

Smoking remains a leading cause of death worldwide, with young adults particularly at risk due to the lack of targeted cessation initiatives. While mobile apps show promise in supporting smoking cessation, they primarily target smokers already motivated enough to install them, highlighting the need for interventions that reach those who are not yet ready to take that step.

Objective:

This paper aims to design and evaluate Smokwit, a digital smoking cessation intervention aimed at young adults during the act of smoking. Smokwit aims to investigate the early stages of smoking cessation (pre-contemplation and contemplation), which are important, yet rarely investigated.

Methods:

The paper is based on the design science research methodology (DSRM) where a digital intervention - Smokwit - was designed and evaluated in-the-wild using a mixed-method approach combining quantitative results of a quasi-experiment with qualitative insights from users and experts. More specifically, Smokwit is a novel gamified ambient intervention that integrates an interactive ashtray with a mobile app. The ashtray aims to provoke curiosity, awareness, self-reflection, and ad-hoc peer discussions among smokers, while the linked mobile app provides smoking cessation self-help material and coaching possibilities. We evaluated the effectiveness of this intervention through a three-month field study in-the-wild designed as a quasi-experiment with a treatment and control group (N=46). A qualitative analysis with users (N=10) as well as smoking cessation experts (N=7) provides further insights into the type of interactions that happened within and outside of the system as well as practical implications for smoking cessation organizations.

Results:

The qualitative findings revealed that the intervention promoted smokers’ self-reflection, peer discussions and mobile app interactions. Furthermore, the quantitative analysis uncovered a suggestive trend (P < .1) that smokers in the intervention condition increased their Readiness to Quit more than those in the control group after the three-month quasi-experiment (???? = 1.799, P = .07).

Conclusions:

The Smokwit intervention provides encouraging insights into how to design a bottom-up digital intervention that targets young adults at an opportune moment to move them along their smoking cessation journey.