scholarly journals A Smartphone App to Leverage Positive Psychology to Support Smoking Cessation in Nondaily Smokers: Results of SiS Study 1 (Preprint)

2018 ◽  
Author(s):  
Bettina Hoeppner ◽  
Susanne Hoeppner ◽  
John Kelly

BACKGROUND The population of nondaily smokers is large (ie, 24.3% of adult smokers) and increasing (ie, 27% increase over the past decade). The cancer risk of nondaily smoking is substantial (40%-50% of that seen in daily smokers). Existing treatments are ill-suited for nondaily smoking, because the treatments are based on nicotine dependence, and traditional treatments and treatment modalities (eg, in-person counseling, medication) do not appeal to non-dependent nondaily smokers. OBJECTIVE We sought to develop a smartphone app that acts as a behavioral, in-the-pocket coach and uses positive psychology exercises to enhance quitting success. METHODS Nondaily smokers (n=30) used Version 1 of the “Smiling Instead of Smoking” (SiS) app while undergoing a quit attempt (1 week pre-, 2 weeks post-quit). The app assigned daily positive psychology exercises, provided smoking cessation tools (ie, scheduling quit day, logging personal reasons for quitting, planning for challenging times, enlisting social support), and made information about smoking cessation available (ie, benefits of quitting, strategies for cravings). Participants answered surveys at baseline and 2, 6, and 12 weeks post-quit and participated in structured user feedback sessions 2 weeks after their chosen quit day. RESULTS During the 3 weeks of ‘prescribed’ use, 50% of participants completed every daily positive psychology exercise, and the remaining 50% completed on average 85% of the daily exercises. Use of the user-initiated tools was limited: 20% did not use the “Challenging Times” tool at all; those who did only used it twice (median); 27% used the “Social Support” tool on multiple days. Self-reported smoking abstinence rates were 43.3% (7-day abstinence) 2 weeks post-quit, and 40.0% and 43.3% (30-day abstinence) at 6 and 12 weeks post-quit, respectively. Most participants (90%) felt the app helped them during their quit attempt, especially in terms of staying on track, giving them confidence, and reinforcing the idea that quitting was worthwhile. Usefulness ratings were particularly high for functionality that allowed participants to (re-)schedule their quit day and log their personal reasons for quitting smoking. In line with putative mechanisms underlying smoking cessation, compared to baseline, participants reported a lower urge to smoke (F(1,29)=20.55, P<.001), increased self-efficacy to abstain from smoking, both in response to internal (F[,29]=12.69, P<.01) and external stimuli (F[1,29]=18.95, P<.001), decreased endorsement of the psychoactive benefits (F[1,29]=16.24, P<.001) and pleasure (F[1,29]=5.44, P=.03) of smoking, and lower perceived importance of the pros of smoking (F[1,29]=18.26, P<.001). Qualitative feedback indicated a desire for more variety in the positive psychology exercises, more recommended strategies for dealing with cravings, less wordy but more frequent behavioral counseling check-ins, a reward systems, and the removal of the “social support” tool. CONCLUSIONS A positive psychology approach to support smoking cessation resonated well with nondaily smokers. App usage of these exercises was high over a 3-week period, suggesting that this treatment approach is sustainable during the critical phase of smoking cessation. Abstinence rates were substantially higher than natural quit rates in this population, and thus offer some promise, which will need to be evaluated in a randomized trial.

2019 ◽  
Author(s):  
Bettina B Hoeppner ◽  
Susanne S Hoeppner ◽  
Hannah A Carlon ◽  
Giselle K Perez ◽  
Eric Helmuth ◽  
...  

BACKGROUND Nondaily smoking is an increasingly prevalent smoking pattern that poses substantial health risks. OBJECTIVE We tested the feasibility of using a smartphone app with positive psychology exercises to support smoking cessation in nondaily smokers. METHODS In this prospective, single-group pilot study, nondaily smokers (n=30) used version 1 of the Smiling Instead of Smoking (SiS) app for 3 weeks while undergoing a quit attempt. The app assigned daily happiness exercises, provided smoking cessation tools, and made smoking cessation information available. Participants answered surveys at baseline and 2, 6, 12, and 24 weeks after their chosen quit day and participated in structured user feedback sessions 2 weeks after their chosen quit day. RESULTS App usage during the prescribed 3 weeks of use was high, with an average 84% (25.2/30) of participants using the app on any given day. App use was largely driven by completing happiness exercises (73%, 22/30) of participants per day), which participants continued to complete even after the end of the prescribed period. At the end of prescribed use, 90% (27/30) of participants reported that the app had helped them during their quit attempt, primarily by reminding them to stay on track (83%, 25/30) and boosting their confidence to quit (80%, 24/30) and belief that quitting was worthwhile (80%, 24/30). Happiness exercises were rated more favorably than user-initiated smoking cessation tools, and 80% (24/30) of participants proactively expressed in interviews that they liked them. App functionality to engage social support was not well received. Functionality to deal with risky times was rated useful but was rarely used. Within-person changes from baseline to the end of prescribed use were observed for several theorized mechanisms of behavior change, all in the expected direction: confidence increased (on a 0-100 scale, internal cues: b=16.7, 95% CI 7.2 to 26.3, P=.001; external cues: b=15.8, 95% CI 5.4 to 26.1, P=.004), urge to smoke decreased (on a 1-7 scale, b=−0.8, 95% CI −1.3 to −0.3, P=.002), and perceptions of smoking became less positive (on a 1-5 scale, psychoactive benefits: b=−0.5, 95% CI −0.9 to −0.2, P=.006; pleasure: b=−0.4, 95% CI −0.7 to −0.01, P=.03; on a 0-100 scale, importance of pros of smoking: b=−11.3, 95% CI −18.9 to −3.8, P=.004). Self-reported abstinence rates were 40% (12/30) and 53% (16/30) of participants 2 and 24 weeks post quit, respectively, with 30% (9/30) biochemically validated as abstinent 2 weeks post quit. CONCLUSIONS A smartphone app using happiness exercises to aid smoking cessation was well received by nondaily smokers. Given the high nonadherence and dropout rates for technology-delivered interventions reported in the literature, the high engagement with positive psychology exercises is noteworthy. Observed within-person changes and abstinence rates are promising and warrant further development of this app.


2021 ◽  
Author(s):  
Bettina B Hoeppner ◽  
Kaitlyn R Siegel ◽  
Hannah A Carlon ◽  
Christopher W Kahler ◽  
Elyse R Park ◽  
...  

BACKGROUND Recent evidence highlights the significant detrimental impact of nondaily smoking on health and its disproportionate prevalence in underserved populations, yet little work has been done to develop treatments specifically geared toward quitting nondaily smoking. OBJECTIVE To test the feasibility, acceptability, and conceptual underpinnings of Version 2 of the “Smiling Instead of Smoking” (SiS2) smartphone app, which was developed specifically for nondaily smokers and uses a positive psychology approach. METHODS Prospective, single-group study of nondaily smokers (n=100) who were prescribed SiS2 app use for seven weeks while undergoing a quit attempt (1 week pre-, 6 weeks post-quit). The app assigned daily positive psychology exercises and behavioral tasks every 2-3 days, which guided smokers through using the smoking cessation tools offered in the app. Participants answered surveys at baseline and 2, 6, 12 and 24 weeks post-quit. Feasibility was evaluated based on app usage and acceptability by survey responses. The underlying conceptual framework was tested by examing if theorized within-person changes occurred from baseline to end-of-treatment on survey scales measuring self-efficacy, desire to smoke, and processing of self-relevant health information (i.e., pros and cons of smoking, importance of pros and cons of quitting, motivation). RESULTS Participants used the SiS2 app on average on 24.7±13.8 days out of the 49 prescribed days. In end-of-treatment surveys, participants indicated that the various functions of the app were “easy” to “very easy” to use. The average score on the System Usability Scale was a 79.8±17.3 (“A” grade; “A+”≥84.1, “B+”<78.8; Sauro, 2011). Most participants indicated that the app helped them in their quit attempt (87%); the app reminded them of why they wanted to quit (92%), helped them prepare for the quit attempt (84%), stay positive while quitting (82%), and deal with risky smoking times (68%). Large effects were found for within-person decreases in desire to smoke (b=-1.5[-1.9,-1.1],p<0.0001,gav=1.01), importance of pros of smoking (b=-20.7[-27.2,-14.3],p<0.0001,gav=0.83), and perceived psychoactive benefits of smoking (b=-0.8[-1.0,-0.5],p<0.0001,gav=0.80). Medium effects were found for increases in self-efficacy for remaining abstinent when encountering internal (b=13.1[7.6,18.7],p<0.0001,gav=0.53) and external (b=11.2[6.1,16.1],p<0.0001,gav=0.49) smoking cues. Smaller effects, and contrary to expectation, were found for decreases in motivation to quit smoking and perceived importance of pros of quitting (ps<0.01). Post-hoc analyses showed that motivation decreased for those who did not succeed in quitting while increasing for those who did (p<0.0001). No such interaction effect existed for the perceived importance of pros of quitting (p=0.94). Self-reported 30-day point prevalence abstinence rates were 40%, 56%, and 56% 6, 12 and 24 weeks after the quit day, respectively. CONCLUSIONS The SiS2 app was feasible and acceptable, showed promising changes on constructs relevant to smoking cessation, and had high self-reported quit rates by nondaily smokers. The SiS2 app warrants testing in a randomized controlled trial. CLINICALTRIAL Trial Registry: Clinicaltrials.gov Registration Number: NCT03951766 URL of Registry: https://clinicaltrials.gov/ct2/show/NCT03951766


Author(s):  
Raymond L. Higgins ◽  
Matthew W. Gallagher

This chapter presents an overview of the development and status of the reality negotiation construct and relates it to a variety of coping processes. The reality negotiation construct follows from the social constructionist tradition and first appeared in discussions of how excuses protect self-images by decreasing the causal linkage to negative outcomes. The reality negotiation construct was later expanded to include a discussion of how the process of hoping may be used to increase perceived linkage to positive outcomes. In the two decades since these constructs were first introduced, four individual differences measures have been developed, and the effects of these reality negotiation techniques have been studied extensively. Reality negotiation techniques can be both maladaptive and adaptive and have been shown to be associated with coping and social support in a variety of populations. The chapter concludes by highlighting a few areas in which reality negotiation research could expand to further its relevance and applicability to the field of positive psychology.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hartine Lehsi ◽  
Sunee Chekabaso ◽  
Muhammadzainuden Mingsu ◽  
Nureehan Maseng ◽  
Thammasin Ingviya

2018 ◽  
Author(s):  
Esther Granado-Font ◽  
Carme Ferré-Grau ◽  
Cristina Rey-Reñones ◽  
Mariona Pons-Vigués ◽  
Enriqueta Pujol Ribera ◽  
...  

BACKGROUND Smoking is one of the most significant factors contributing to low life expectancy, health inequalities, and illness at the worldwide scale. Smoking cessation attempts benefit from social support. Mobile phones have changed the way we communicate through the use of freely available message-oriented apps. Mobile app–based interventions for smoking cessation programs can provide interactive, supportive, and individually tailored interventions. OBJECTIVE This study aimed to identify emotions, coping strategies, beliefs, values, and cognitive evaluations of smokers who are in the process of quitting, and to analyze online social support provided through the analysis of messages posted to a chat function integrated into a mobile app. METHODS In this descriptive qualitative study, informants were smokers who participated in the chat of Tobbstop. The technique to generate information was documentary through messages collected from September 2014 through June 2016, specifically designed to support a smoking cessation intervention. A thematic content analysis of the messages applied 2 conceptual models: the Lazarus and Folkman model to assess participant’s experiences and perceptions and the Cutrona model to evaluate online social support. RESULTS During the study period, 11,788 text messages were posted to the chat by 101 users. The most frequent messages offered information and emotional support, and all the basic emotions were reported in the chat. The 3 most frequent coping strategies identified were physical activity, different types of treatment such as nicotine replacement, and humor. Beliefs about quitting smoking included the inevitability of weight gain and the notion that not using any type of medications is better for smoking cessation. Health and family were the values more frequently described, followed by freedom. A smoke-free environment was perceived as important to successful smoking cessation. The social support group that was developed with the app offered mainly emotional and informational support. CONCLUSIONS Our analysis suggests that a chat integrated into a mobile app focused on supporting smoking cessation provides a useful tool for smokers who are in the process of quitting, by offering social support and a space to share concerns, information, or strategies.


Author(s):  
Matthew W. Gallagher

This chapter presents an overview of the development and status of the reality negotiation construct and relates it to a variety of coping processes. The reality negotiation construct follows from the social constructionist tradition and first appeared in discussions of how excuses protect self-images by decreasing the causal linkage to negative outcomes. The reality negotiation construct was later expanded to include a discussion of how the process of hoping may be used to increase perceived linkage to positive outcomes. In the three decades since these constructs were first introduced, five individual differences measures have been developed, and the effects of these reality negotiation techniques have been studied extensively. Reality negotiation techniques can be both maladaptive and adaptive and have been shown to be associated with coping and social support in a variety of populations. The chapter concludes by highlighting a few areas in which reality negotiation research could expand to further its relevance and applicability to the field of positive psychology.


2009 ◽  
Vol 4 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Lorien C. Abroms ◽  
Jennifer Gill ◽  
Richard Windsor ◽  
Bruce Simons-Morton

AbstractBackground: Few smoking cessation interventions have made extensive use of e-mail. Objective: This study set out to document how the e-mail component of an e-mail-based smoking cessation program was received by college smokers. Methods: Participants were randomised after enrolment to receive either a moderately intensive, e-mail-based intervention — the X-Pack Group — or a less intensive program based on a widely available smoking cessation guidebook. Participants were assessed at baseline and 3 months post-enrolment. This analysis is limited to those in the X-Pack Group (n = 48). Results: Twelve e-mails on average were sent out to each participant over the course of 6 months. Ninety-one per cent of participants reported reading all or most of the e-mails and 73% replied to at least one of the e-mails they received. On average, participants were positive about the e-mails received and most reported that they had liked the e-mails because of the social support and encouragement provided. The average time for counsellors to write and send each e-mail from the templates was 12 minutes, with a range from 2 to 60 minutes. Conclusions: These findings offer evidence of feasibility of an e-mail-based smoking cessation intervention in a college population.


Author(s):  
Qinghua Yang

Despite the ubiquity of smartphone ownership and the increasing integration of social engagement features in smoking cessation apps to engage users, the social and non-social engagement features that are present in current smoking cessation apps and the effectiveness of these features in engaging users remain understudied. To fill the gap in the literature, a content analysis of free and paid smoking cessation mobile apps was conducted to examine (a) the presence of social features (i.e., social support, social announcement, and social referencing) and non-social engagement features (e.g., personal environmental changes, goal setting, progress tracking, reinforcement tracking, self-monitoring, and personalized recommendations) and (b) their relationships with user engagement scores measured by the Mobile App Rating Scale. In this study, 28.2% of the smoking cessation apps enable social announcement and 8.1% offered the social support feature. Only two apps provided a social referencing feature (1.3%). No app included reinforcement tracking, with the percentage of other non-social engagement features ranging from 9.4% to 49.0%. Social support (β = 0.30, p < 0.001), social announcement (β = 0.21, p < 0.05), and social referencing (β = 0.18, p < 0.05) were significant predictors of user engagement. Regarding the non-social engagement features, personal environment changes (β = 0.38, p < 0.001), progress tracking (β = 0.18, p < 0.05), and personalized recommendations (β = 0.37, p < 0.001) significantly predicted user engagement. The findings not only contribute to the mobile communication literature by applying and extending the theory-based mobile health apps engagement typology, but also inform the future architecture design of smoking cessation mobile apps.


10.2196/13436 ◽  
2019 ◽  
Vol 7 (7) ◽  
pp. e13436 ◽  
Author(s):  
Bettina B Hoeppner ◽  
Susanne S Hoeppner ◽  
Hannah A Carlon ◽  
Giselle K Perez ◽  
Eric Helmuth ◽  
...  

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