Abstract

Cigarette smoking remains the leading cause of preventable death in the United States. Traditional in-clinic cessation interventions may fail to intervene and interrupt the rapid progression to relapse that typically occurs following a quit attempt. The ability to detect actual smoking behavior in real-time is a measurement challenge for health behavior research and intervention. The successful detection of real-time smoking through mobile health (mHealth) methodology has substantial implications for developing highly efficacious treatment interventions. The current study was aimed at further developing and testing the ability of inertial sensors to detect cigarette smoking arm movements among smokers. The current study involved four smokers who smoked six cigarettes each in a laboratory-based assessment. Participants were outfitted with four inertial body movement sensors on the arms, which were used to detect smoking events at two levels: the puff level and the cigarette level. Two different algorithms (Support Vector Machines (SVM) and Edge-Detection based learning) were trained to detect the features of arm movement sequences transmitted by the sensors that corresponded with each level. The results showed that performance of the SVM algorithm at the cigarette level exceeded detection at the individual puff level, with low rates of false positive puff detection. The current study is the second in a line of programmatic research demonstrating the proof-of-concept for sensor-based tracking of smoking, based on movements of the arm and wrist. This study demonstrates efficacy in a real-world clinical inpatient setting and is the first to provide a detection rate against direct observation, enabling calculation of true and false positive rates. The study results indicate that the approach performs very well with some participants, whereas some challenges remain with participants who generate more frequent non-smoking movements near the face. Future work may allow for tracking smoking in real-world environments, which would facilitate developing more effective, just-in-time smoking cessation interventions.

Highlights

  • Cigarette smoking remains the number one cause of preventable morbidity and mortality in the United States [1]

  • All of these techniques suffer from limitations in accurately detecting smoking status and patterns of use, which may contribute to the deficits in existing smoking cessation interventions

  • Ecological momentary assessment (EMA) is intended to collect information about individual smoking events as they occur in the natural environment; EMA suffers from the same potential limitations that exist for other self-report measures described above and requires high levels of participant compliance

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Summary

Introduction

Cigarette smoking remains the number one cause of preventable morbidity and mortality in the United States [1]. A number of methods are used to estimate smoking status in research and treatment methods, such as: (1) self-reports of smoking status at specific time points [6]; (2) self-reports of smoking in the natural environment at the time that each cigarette is smoked (e.g., ecological momentary assessment; [7]; (3) expired breath carbon monoxide (CO; [8,9]); and (4) metabolites of nicotine found in the urine, saliva, and blood plasma of smokers, such as cotinine [8,10,11] All of these techniques suffer from limitations in accurately detecting smoking status and patterns of use, which may contribute to the deficits in existing smoking cessation interventions. Biochemical measures of abstinence do not capture individual smoking events, instead they provide a summary of smoking, and occasionally fail to identify very low levels of smoking [8]

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