A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study.

Carol C Choo,Yi Zhuang Tan,Melvyn W B Zhang

doi:10.2196/22582

Abstract

BackgroundSmoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic.ObjectiveThis study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app.MethodsIn all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app.ResultsThe results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement.ConclusionsFindings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

Highlights

Smoking remains a global health threat [1,2], and it is compounded by adverse relationships with depression and anxiety [3], as well as the consequences of secondhand smoke [4]
The results showed that attentional bias toward smoking-related stimuli and subjective craving decreased over the week in the attentional bias retraining group
Similar to previous research [41], in this pilot study, we investigated attentional bias retraining delivered via the novel smartphone app by quantitatively analyzing the attentional bias to smoking cues, subjective craving of smoking, and smoking frequency of current adult smokers who did and did not undertake attentional bias retraining

Summary

Introduction

Background Smoking remains a global health threat [1,2], and it is compounded by adverse relationships with depression and anxiety [3], as well as the consequences of secondhand smoke [4]. Despite the growing impetus for smoking cessation efforts [1,2], as smoking is prevalent, smokers are constantly exposed to smoking-related cues in the environment [2,5]. Hyperattention to such stimuli imposes obstacles to any attempts at abstinence owing to the unconscious process of attentional bias [5,6]. There is a bidirectional relationship between attentional bias cues and subjective craving for a substance [9]. Attentional bias toward the substance is further increased, which consolidates the cycle of craving and attentional bias in addiction. Attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic

Objectives

Methods

Results

Discussion

Conclusion