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Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation
BACKGROUND: Tobacco smoking is the leading cause of preventable death in the United States, and the annual economic burden attributable to smoking exceeds US $300 billion. Obstacles to smoking cessation include limited access and adherence to effective cessation interventions. Technology can help ov...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424127/ https://www.ncbi.nlm.nih.gov/pubmed/28442453 http://dx.doi.org/10.2196/mhealth.7226 |
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author | Iacoviello, Brian M Steinerman, Joshua R Klein, David B Silver, Theodore L Berger, Adam G Luo, Sean X Schork, Nicholas J |
author_facet | Iacoviello, Brian M Steinerman, Joshua R Klein, David B Silver, Theodore L Berger, Adam G Luo, Sean X Schork, Nicholas J |
author_sort | Iacoviello, Brian M |
collection | PubMed |
description | BACKGROUND: Tobacco smoking is the leading cause of preventable death in the United States, and the annual economic burden attributable to smoking exceeds US $300 billion. Obstacles to smoking cessation include limited access and adherence to effective cessation interventions. Technology can help overcome these obstacles; many smartphone apps have been developed to aid smoking cessation, but few that conform to the US clinical practice guideline (USCPG) have been rigorously tested and reported in the literature. Clickotine is a novel smartphone app for smoking cessation, designed to deliver the essential features of the USCPG and engineered to engage smokers by personalizing intervention components. OBJECTIVE: Our objective was to assess the engagement, efficacy, and safety of Clickotine in an initial, single-arm study. Outcomes measured were indicators of engagement with the smartphone app (number of app opens, number of interactions with the Clickotine program, and weeks active with Clickotine), cessation outcomes of 7- and 30-day self-reported abstinence from smoking, and negative health events. METHODS: We recruited US residents between 18 and 65 years of age who owned an iPhone and smoked 5 or more cigarettes daily for the study via online advertising. Respondents were prescreened for eligibility by telephone and, if appropriate, directed to a Web portal to provide informed consent, confirm eligibility, and download the Clickotine app. Participants completed study assessments via the online portal at baseline and after 8 weeks. Data were collected in Amazon S3 with no manual data entry, and access to all data was maximally restrictive, logged, and auditable. RESULTS: A total of 416 participants downloaded the app and constituted the intention-to-treat (ITT) sample. On average, participants opened the Clickotine app 100.6 times during the 8-week study (median 69), logged 214.4 interactions with the Clickotine program (median 178), and remained engaged with Clickotine for 5.3 weeks (median 5). Among the ITT sample, 45.2% (188/416) reported 7-day abstinence and 26.2% (109/416) reported 30-day abstinence from smoking after 8 weeks. Completer analysis focused on 365 (87.7%) of the 416 enrolled participants who completed the 8-week questionnaire revealed that 51.5% (188/365) of completers reported 7-day abstinence and 29.9% (109/365) reported 30-day abstinence. Few adverse events, mostly consistent with nicotine withdrawal symptoms, were reported and overall no safety signal was detected. CONCLUSIONS: In this initial single-arm trial, Clickotine users appeared to demonstrate encouraging indicators of engagement in terms of the number of app opens, number of program interactions, and continued engagement over time. Clickotine users reported encouraging quit rates while reporting few adverse events. Future research is warranted to assess Clickotine’s efficacy in a randomized controlled trial. TRIAL REGISTRATION: Clinicaltrials.gov NCT02656745; https://clinicaltrials.gov/ct2/show/NCT02656745 (Archived by WebCite at http://www.webcitation.org/6peTT4x60) |
format | Online Article Text |
id | pubmed-5424127 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-54241272017-05-17 Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation Iacoviello, Brian M Steinerman, Joshua R Klein, David B Silver, Theodore L Berger, Adam G Luo, Sean X Schork, Nicholas J JMIR Mhealth Uhealth Original Paper BACKGROUND: Tobacco smoking is the leading cause of preventable death in the United States, and the annual economic burden attributable to smoking exceeds US $300 billion. Obstacles to smoking cessation include limited access and adherence to effective cessation interventions. Technology can help overcome these obstacles; many smartphone apps have been developed to aid smoking cessation, but few that conform to the US clinical practice guideline (USCPG) have been rigorously tested and reported in the literature. Clickotine is a novel smartphone app for smoking cessation, designed to deliver the essential features of the USCPG and engineered to engage smokers by personalizing intervention components. OBJECTIVE: Our objective was to assess the engagement, efficacy, and safety of Clickotine in an initial, single-arm study. Outcomes measured were indicators of engagement with the smartphone app (number of app opens, number of interactions with the Clickotine program, and weeks active with Clickotine), cessation outcomes of 7- and 30-day self-reported abstinence from smoking, and negative health events. METHODS: We recruited US residents between 18 and 65 years of age who owned an iPhone and smoked 5 or more cigarettes daily for the study via online advertising. Respondents were prescreened for eligibility by telephone and, if appropriate, directed to a Web portal to provide informed consent, confirm eligibility, and download the Clickotine app. Participants completed study assessments via the online portal at baseline and after 8 weeks. Data were collected in Amazon S3 with no manual data entry, and access to all data was maximally restrictive, logged, and auditable. RESULTS: A total of 416 participants downloaded the app and constituted the intention-to-treat (ITT) sample. On average, participants opened the Clickotine app 100.6 times during the 8-week study (median 69), logged 214.4 interactions with the Clickotine program (median 178), and remained engaged with Clickotine for 5.3 weeks (median 5). Among the ITT sample, 45.2% (188/416) reported 7-day abstinence and 26.2% (109/416) reported 30-day abstinence from smoking after 8 weeks. Completer analysis focused on 365 (87.7%) of the 416 enrolled participants who completed the 8-week questionnaire revealed that 51.5% (188/365) of completers reported 7-day abstinence and 29.9% (109/365) reported 30-day abstinence. Few adverse events, mostly consistent with nicotine withdrawal symptoms, were reported and overall no safety signal was detected. CONCLUSIONS: In this initial single-arm trial, Clickotine users appeared to demonstrate encouraging indicators of engagement in terms of the number of app opens, number of program interactions, and continued engagement over time. Clickotine users reported encouraging quit rates while reporting few adverse events. Future research is warranted to assess Clickotine’s efficacy in a randomized controlled trial. TRIAL REGISTRATION: Clinicaltrials.gov NCT02656745; https://clinicaltrials.gov/ct2/show/NCT02656745 (Archived by WebCite at http://www.webcitation.org/6peTT4x60) JMIR Publications 2017-04-25 /pmc/articles/PMC5424127/ /pubmed/28442453 http://dx.doi.org/10.2196/mhealth.7226 Text en ©Brian M Iacoviello, Joshua R Steinerman, David B Klein, Theodore L Silver, Adam G Berger, Sean X Luo, Nicholas J Schork. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.04.2017. https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/ (https://creativecommons.org/licenses/by/2.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Iacoviello, Brian M Steinerman, Joshua R Klein, David B Silver, Theodore L Berger, Adam G Luo, Sean X Schork, Nicholas J Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title | Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title_full | Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title_fullStr | Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title_full_unstemmed | Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title_short | Clickotine, A Personalized Smartphone App for Smoking Cessation: Initial Evaluation |
title_sort | clickotine, a personalized smartphone app for smoking cessation: initial evaluation |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424127/ https://www.ncbi.nlm.nih.gov/pubmed/28442453 http://dx.doi.org/10.2196/mhealth.7226 |
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