@Article{info:doi/10.2196/24976,
author="Peek, Jenny
and Hay, Karen
and Hughes, Pauline
and Kostellar, Adrienne
and Kumar, Subodh
and Bhikoo, Zaheerodin
and Serginson, John
and Marshall, Henry M",
title="Feasibility and Acceptability of a Smoking Cessation Smartphone App (My QuitBuddy) in Older Persons: Pilot Randomized Controlled Trial",
journal="JMIR Form Res",
year="2021",
month="Apr",
day="14",
volume="5",
number="4",
pages="e24976",
keywords="mHealth; mobile apps; motivation; smartphone; smoking cessation; tobacco smoking",
abstract="Background: Although many smoking cessation smartphone apps exist, few have been independently evaluated, particularly in older populations. In 2017, of the 112 commercially available smoking cessation apps in Australia, only 6 were deemed to be of high quality, in that they partially adhered to Australian guidelines. Mobile health (mHealth) apps have the potential to modify smoking behavior at a relatively low cost; however, their acceptability in older smokers remains unknown. Rigorous scientific evaluation of apps is thus urgently needed to assist smokers and clinicians alike. Objective: We conducted a pilot randomized controlled trial to evaluate the feasibility of a large-scale trial to assess the use and acceptability of a high-quality smoking cessation app in older smokers. Methods: Adult inpatient and outpatient smokers with computer and smartphone access were recruited face to face and via telephone interviews from Metropolitan Hospitals in Brisbane, Australia. Participants were randomized 1:1 to the intervention (requested to download the ``My QuitBuddy'' smoking cessation app on their smartphone) or the control group (provided access to a tailored smoking cessation support webpage [Quit HQ]). The My QuitBuddy app is freely available from app stores and provides personalized evidenced-based smoking cessation support. Quit HQ offers regular email support over 12 weeks. No training or instructions on the use of these e-resources were given to participants. Outcomes at 3 months included recruitment and retention rates, use and acceptability of e-resource (User Version of the Mobile App Rating Scale [uMARS]), changes in quitting motivation (10-point scale), and self-reported smoking abstinence. Results: We randomized 64 of 231 potentially eligible individuals (27.7{\%}). The mean age of participants was 62 (SD 8). Nicotine dependence was moderate (mean Heaviness of Smoking Index [HSI] 2.8 [SD 1.2]). At 3 months the retention rate was (58/64, 91{\%}). A total of 15 of 31 participants in the intervention arm (48{\%}) used the app at least once, compared with 10 of 33 (30{\%}) in the control arm. uMARS scores for e-resource use and acceptability were statistically similar (P=.29). Motivation to quit was significantly higher in the intervention arm compared with the control arm (median 6 [IQR 4-8] versus 4 [IQR 4-5], respectively, P=.02). According to the intention-to-treat analysis, smoking abstinence was nonsignificantly higher in the intervention group (4/31 [13{\%}], 95{\%} CI 4{\%}-30{\%}, versus 2/33 [6{\%}], 95{\%} CI 1{\%}-20{\%}; P=.42). The estimated number needed to treat was 14. Conclusions: Internet and mHealth smoking cessation resources appear acceptable to a minority of older smokers. Smokers who engaged with the allocated e-resources rated them equally, and there were trends toward greater uptake, increased motivation, and higher abstinence rates in the app group; however, only the change in motivation reached statistical significance (median score 6 versus 4, respectively, P=.02). This results of this pilot study suggest that apps may improve quit outcomes in older adults who are willing to use them. Further research into user--app interactions should be undertaken to facilitate improvements in app design and consumer engagement. These favorable trends should be explored in larger trials with sufficient statistical power. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619000159156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376849{\&}isReview=true ",
issn="2561-326X",
doi="10.2196/24976",
url="https://formative.jmir.org/2021/4/e24976",
url="https://doi.org/10.2196/24976",
url="http://www.ncbi.nlm.nih.gov/pubmed/33851923"
}