Smoking Cessation Smartphone Application Use Over Time: Do Usage Patterns Predict 12-month Cessation
Thursday, August 18, 2022
Posted by: Natalia Gromov
Bricker
J, Mull K, Santiago-Torres M, Miao Z, Perski O, Di C.
Smoking Cessation
Smartphone Application Use Over Time: Do Usage Patterns Predict 12-month
Cessation Outcomes?
[published online ahead of print, 2022 Jul 13]. J Med Internet Res.
2022;10.2196/39208. doi:10.2196/39208
Background. Little
is known about how individuals engage over time with smartphone application
interventions and whether this engagement predicts health outcomes.
Objective. In
the context of a randomized trial comparing two smartphone applications (apps)
for smoking cessation, to determine: (1) distinct groups of smartphone app
login trajectories over a 6-month period, (2) their association with smoking
cessation outcomes at 12-months, and (3) baseline user characteristics that
predict data-driven trajectory group membership.
Methods. Functional
clustering of 182 consecutive days of smoothed login data from both arms of a
large (N = 2415) randomized trial of two smartphone apps for smoking cessation
(iCanQuit and QuitGuide) was used to identify distinct trajectory groups.
Logistic regression was used to determine the association of group membership
with the primary outcome of 30-day point prevalence smoking abstinence at 12
months. Finally, baseline characteristics associated with group membership were
examined using logistic and multinomial logistic regression. Analyses were
conducted separately for each app.
Results. For
iCanQuit, participants were clustered into three groups: "1-week
users" (n=610, 57% of the sample), "4-week users" (n=303, 28%),
and "26-week users" (n=156, 15%). For smoking cessation rates at the
12-month follow-up, compared to 1-week users, 4-week users had 50% higher odds
of cessation (30% vs. 23%; OR = 1.50; 95% CI = 1.05, 2.14; p = .027) whereas
26-week users had 397% higher odds (56% vs. 23%; OR = 4.97; 95% CI = 3.31,
7.52; p < .001). For QuitGuide, participants were clustered into two groups:
"1-week users" (n=695, 65% of the sample), and "3-week
users" (n=369, 35%). The difference in the odds of being abstinent at
12-months for 3-week users vs. 1-week users was minimal (23% vs. 21%; OR =
1.16; 95% CI = 0.84, 1.62; p = .370). Different baseline characteristics
predicted trajectory group membership for each app.
Conclusions. Patterns
of 1-, 3-, and 4-week usage of smartphone apps for smoking cessation may be
common for how people engage in digital health interventions. There were
significant higher odds of quitting smoking among 4-week users, and especially
among 26-week users of the iCanQuit application. To improve study outcomes,
strategies for detecting users who disengage early from these interventions
(1-week users) and proactively offering them a more intensive intervention
could be fruitful.
Clinical trial. Clinical
Trials.gov Registration Number: NCT02724462.
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