An mHealth App for Supporting Quitters to Manage Cigarette Cravings With Short Bouts of Physical Activity: A Randomized Pilot Feasibility and Acceptability Study.

Mary Hassandra,Martin S Hagger,Tarja Kettunen,Mauno Vanhala,Taru Lintunen,Risto Heikkinen

doi:10.2196/mhealth.6252

Abstract

BackgroundWhile gains in reducing smoking rates in Finland have been made, prevalence rates are still substantial. Relapse rates among smokers engaged in quit-smoking programs are high. Physical activity has been proposed as one means to help smokers manage cravings. Software and apps on mobile phone and handheld devices offer an opportunity to communicate messages on how to use physical activity to manage cravings as part of quit-smoking programs.ObjectiveWe aimed to test the feasibility, acceptability, usability, and preliminary efficacy of an mHealth mobile phone app, Physical activity over Smoking (PhoS), to assist smokers in quitting smoking in a randomized controlled trial. The app was designed to prompt smokers to engage in physical activities to manage their smoking cravings.MethodsRegular smokers (n=44) attended a group-based behavioral counselling program aimed at promoting physical activity as an additional aid to quit. After quit day, participants were randomly allocated to an intervention (n=25) or to a comparison (n=19) group. Participants in the intervention group were provided with the PhoS app and training on how to use it to assist with relapse prevention. Participants in the comparison condition were provided with generalized relapse prevention training.ResultsSome participants reported that the PhoS app was useful in assisting them to successfully manage their cigarette cravings, although compliance across the sample was modest and participants reported low levels of usability. Participants receiving the PhoS app did not report greater abstinence than those who did not receive the app. However, participants receiving the app were more likely to report greater abstinence if they did not use pharmacological support, while those who did not receive the app reported greater abstinence when using pharmacological support. Participants receiving the app reported greater levels of physical activity than those who did not. Results revealed that the app resulted in better retention.ConclusionsThe PhoS app showed some potential to reduce abstinence among participants not using pharmacological therapy and to increase physical activity. However, problems with usability and lack of effects on abstinence raise questions over the app’s long-term effectiveness. Future research should prioritize further development of the app to maximize usability and test effects of the intervention independent of quit-smoking programs.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 55259451; http://www.controlled-trials.com/ISRCTN55259451 (Archived by WebCite at http://www.webcitation.org/6cKF2mzEI)

Highlights

The harmful effects of smoking on health are well documented, but quit rates are low and long-term relapse rates range from 75%, for smokers adopting combined therapies of counseling and pharmacotherapy to assist quitting, to 95%, for smokers who adopt a complete abstinence (“cold turkey”) strategy without pharmacological or therapeutic support [1,2,3]
Behavioral interventions delivered through mobile phones and handheld devices offer promising opportunities to expand psychological practice [6,7], and the integration of effective behavior change interventions using software in these devices [8] may help develop stronger evidence in future research in this field
Evidence of the positive effects of physical activity on reducing cravings is promising [13,14,15,16], most of the research focuses on acute, short-term effects, and findings are limited by a lack of long-term follow-up and a focus on laboratory-based studies

Summary

Introduction

The harmful effects of smoking on health are well documented, but quit rates are low and long-term relapse rates range from 75%, for smokers adopting combined therapies of counseling and pharmacotherapy to assist quitting, to 95%, for smokers who adopt a complete abstinence (“cold turkey”) strategy without pharmacological or therapeutic support [1,2,3]. There is good evidence for the acute, short-term effects of physical activity on smoking-related variables. Research has indicated that physical activity acutely reduces cigarette craving [13,14,15]. There is a need for interventions to examine the long-term effects of physical activity on cigarette cravings and smoking cessation in real-life situations. Similar efforts in this line of research have been initiated [17,18], but none have adopted mobile technology and mHealth apps. Software and apps on mobile phone and handheld devices offer an opportunity to communicate messages on how to use physical activity to manage cravings as part of quit-smoking programs

Methods

Results

Discussion

Conclusion