Using a Mobile App to Promote Smoking Cessation in Hospitalized Patients

Joseph Finkelstein, Eun Me Cha, Joseph Finkelstein, Eun Me Cha

Abstract

Background: The potential of interactive health education for preventive health applications has been widely demonstrated. However, use of mobile apps to promote smoking cessation in hospitalized patients has not been systematically assessed.

Objective: This study was conducted to assess the feasibility of using a mobile app for the hazards of smoking education delivered via touch screen tablets to hospitalized smokers.

Methods: Fifty-five consecutive hospitalized smokers were recruited. Patient sociodemographics and smoking history was collected at baseline. The impact of the mobile app was assessed by measuring cognitive and behavioral factors shown to promote smoking cessation before and after the mobile app use including hazards of smoking knowledge score (KS), smoking attitudes, and stages of change.

Results: After the mobile app use, mean KS increased from 27(3) to 31(3) ( P<0.0001). Proportion of patients who felt they "cannot quit smoking" reduced from 36% (20/55) to 18% (10/55) ( P<0.03). Overall, 13% (7/55) of patients moved toward a more advanced stage of change with the proportion of patients in the preparation stage increased from 40% (22/55) to 51% (28/55). Multivariate regression analysis demonstrated that knowledge gains and mobile app acceptance did not depend on age, gender, race, computer skills, income, or education level. The main factors affecting knowledge gain were initial knowledge level ( P<0.02), employment status ( P<0.05), and high app acceptance ( P<0.01). Knowledge gain was the main predictor of more favorable attitudes toward the mobile app (odds ratio (OR)=4.8; 95% confidence interval (CI) (1.1, 20.0)). Attitudinal surveys and qualitative interviews identified high acceptance of the mobile app by hospitalized smokers. Over 92% (51/55) of the study participants recommended the app for use by other hospitalized smokers and 98% (54/55) of the patients were willing to use such an app in the future.

Conclusions: Our results suggest that a mobile app promoting smoking cessation is well accepted by hospitalized smokers. The app can be used for interactive patient education and counseling during hospital stays. Development and evaluation of mobile apps engaging patients in their care during hospital stays is warranted.

Keywords: health literacy; hospital; mobile apps; patient engagement; smoking cessation.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Scatterplot of post-KS against pre-KS values stratified by race (circles: African Americans, squares: American Indians/Alaska Natives, stars: Caucasians).
Figure 2
Figure 2
Distribution of stages of change before and after the mobile app use (gray bars: before the app use, black bars: after the app use; see detailed description in the text).

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