Research article
iPhone Apps for Smoking Cessation: A Content Analysis

https://doi.org/10.1016/j.amepre.2010.10.032Get rights and content

Background

With the proliferation of smartphones such as the iPhone, mobile phones are being used in novel ways to promote smoking cessation.

Purpose

This study set out to examine the content of the 47 iPhone applications (apps) for smoking cessation that were distributed through the online iTunes store, as of June 24, 2009.

Methods

Each app was independently coded by two reviewers for its (1) approach to smoking cessation and (2) adherence to the U.S. Public Health Service's 2008 Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Each app was also coded for its (3) frequency of downloads.

Results

Apps identified for smoking cessation were found to have low levels of adherence to key guidelines in the index. Few, if any, apps recommended or linked the user to proven treatments such as pharmacotherapy, counseling, and/or a quitline.

Conclusions

iPhone apps for smoking cessation rarely adhere to established guidelines for smoking cessation. It is recommended that current apps be revised and future apps be developed around evidence-based practices for smoking cessation.

Introduction

Mobile phones have shown some promise in helping people quit smoking and modifying other health behaviors.1, 2, 3, 4 Most of these phone-based interventions have relied on the text-messaging feature of mobile phones and consisted of a series of short, and sometimes interactive set of text messages that guide a person through the process of behavior change.

However, with the proliferation of smartphones, there are new possibilities for using mobile phones as tools for health promotion. Smartphones have powerful operating systems that can run computer programs or applications (apps), in addition to the standard features of mobile phones.5, 6 Among smartphones, the iPhone is notable because since its release in 2007, third parties have been able to create apps for the iPhone operating system and distribute them to the public through a common online website, the Apple iTunes store. To date, the Apple iTunes store has released more than 100,000 iPhone apps, which have been downloaded by consumers more than 3 billion times.7, 8 Of the applications that have been released, 20 have previously been identified as smoking-cessation apps.9

Few studies have examined the content quality of iPhone apps for a given health behavior or condition. The present study examines the content of existing iPhone apps as they apply to smoking cessation. Of interest is the degree to which these apps adhere to established best practices in smoking cessation, their popularity among iPhone users, and the relationship between these variables.

Section snippets

Methods

A list of applications was collected on June 24, 2009, using the Power Search function of iTunes version 8.1, available for download at www.apple.com/itunes. The search was restricted to apps compatible with the iPhone. The phrases quit smoking, stop smoking, and smoking cessation were used as search queries.10 The search initially identified 62 unique apps. Apps that included a basic and deluxe version were counted as separate apps in the event that they might differ in their smoking-cessation

Results

The characteristics of the 47 smoking-cessation apps included in the analysis are presented in Table 1. The mean adherence index score for all apps in the sample was 7.8, and adherence scores ranged from 0 to 30 of a total of 60 points. The mean price for an app was $1.82, and prices ranged from free to $9.99. Most apps used a calculator approach (31.9%), followed by a calendar (27.7%), rationing (10.6%), hypnosis (6.4%), and other (23.4%) approach. Of the apps that were categorized as using an

Discussion

iPhone apps for smoking cessation available in mid-2009 had low levels of adherence to proven strategies for smoking cessation. Hypnosis and calendar apps that tracked days until and after user's quit date dominated what users chose to download, and apps that were more frequently downloaded had the lowest adherence scores.

Few apps referred the user to a recommended treatment, and none strongly endorsed the use of approved medications or the combination of counseling and medication. Apps largely

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