BACKGROUND
Mobile health apps can facilitate access to effective treatment and therapeutic information services. However, the real-world effectiveness of mobile applications for smoking cessation and their potential impact in everyday settings remain unclear.
OBJECTIVE
In an ecological context, this study aims to estimate the engagement rate of a mobile app smoking cessation preparation program and its potential impact on users’ willingness, ability, and readiness to quit smoking.
METHODS
A total of 2331 organic users chose to pursue 1 of 2 program versions proposed by the mobile app: the basic version or the premium version. Both versions were identical in design, with 4 more evidence-based content and strategies for the premium version. Outcomes were analyzed based on automated data registered in the app (engagement rate, motif to quit, motivation type, motivation levels, and satisfaction level). Mann-Whitney and chi-square tests were used to compare the results of both groups.
RESULTS
As expected, in the ecological context, a high dropout rate was observed at different moments. A significant difference was observed between the 2 versions (χ21=5.43; P=.02) with a proportionally higher engagement rate in the premium version (Premium=4.7% vs Basic=2%). Likewise, differences were also observed between the 2 groups in terms of reasons to quit (χ24=19; P=.001), motivation type (χ27=14.7; P=.04), and motivation level. Users with the app’s premium version more frequently reported “Well-being” (23.3% vs 17.9%) and “Baby project” (7.4% vs 4.4%) as their primary reasons for quitting smoking compared to those with the basic version. Moreover, they reported being more likely to be driven in a smoking cessation process by intrinsic motivation (Premium=28% vs Basic=20.4%) as well as significantly feeling more willing (z=156,055; P=<.001; d=0.15), able (z=172,905; P=.04; d=0.09), and ready (z score=166,390; P=.005; d=0.12) to stop smoking than users who had the basic version before competition of the preparation program. Among participants who finished each version of the program (Premium: 47/2142= 2%; Basic 9/189= 4.7%), substantial improvements in motivation levels were observed in both groups, although in different areas for each group (willingness levels for the premium group and ability for the basic group).
CONCLUSIONS
These results suggest that even in ecological contexts where engagement rates are meager, the Kwit’s preparation program can address ambivalence by increasing willingness to change, self-confidence, and readiness to quit among its users, especially those who felt less able to do so. Further development and evaluations are needed to better understand determinants for regular M-health mobile apps.