E-cigarettes are gaining popularity amongst youth
Smoking is the number one cause of preventable death in the world. The total number of youth and young adults who started smoking increased from 1.9 million in 2002 to 2.3 million in 2012 (1). The current landscape is made more complex by new tobacco products which are being introduced into the market. In 2014, 13.4% of US high school students reported to have had an e-cigarette in the last 30 days, an increase from 0.6% in 2011 (2).
Amongst 12-49 year old daily smokers, new smokers began smoking on average at 20.1 years old (3). The severity of nicotine addiction is greater amongst those who start smoking at an early age, making smoking cessation amongst youth and young adults an important focus for research.
#####(1) U.S. Department of Health and Human Services. 2014. The Health Consequences of Smoking —50 Years of Progress: A ReportWhitten, L. 2009.
#####(2) Centers for Disease Control and Prevention. Tobacco Use Among Middle and High School Students—United States, 2011–2014. Morbidity and Mortality Weekly Report, 2015;64(14):381–5 [accessed 2015 Jul 24].
#####(3) Nielsen. 2013. Mobile Majority: U.S. Smartphone ownership tops 60%.
Young people have the highest smartphone ownership and social media use
Smartphone ownership in the US is especially high amongst youth and young adults. During 2013, 61% of mobile users owned a smartphone, with ownership highest among those aged 25-34 at 78%, closely followed by the 18-24 age group at 75% (4). Smartphone ownership continues to rise, with a predicted 58.5% or 192.4 million US consumers are predicted to own a smartphone by 2016 (5).
Smartphones are an important part of the social media landscape. Activity on social networks, such as connecting and engaging in real time, is particularly characteristic to mobile use. Comparing smartphones to laptops, a study in 2011 observed that “smartphone use is signiﬁcantly shorter in duration, more evenly spread throughout the day, and nearly twice as abundant (in terms of total time spent using the device)” (6). And it’s no suprise that smartphone-owning teens are avid users of a number of social media applications—91% of teen smartphone owners use social networking sites (7).
#####(4) Nielsen. 2013. Mobile Majority: U.S. Smartphone ownership tops 60%. Retrieved from http://www.nielsen.com/us/en/newswire/2013/mobile-majority–u-s–smartphone-ownership-tops-60-.html.
#####(5) eMarketer. 2012. Smartphones Continue to Gain Share as US Mobile Usage Plateaus. Retrieved from http://www.emarketer.com/Article/Smartphones-Continue-Gain-Share-US-Mobile-Usage-Plateaus/1008958.
#####(6) Oulasvirta, A.,T. Rattenbury, L. Ma, E. Raita. 2011.Habits make smartphone use more pervasive. Journal Personal and Ubiquitous Computing 16:105-114.
#####(7) DeFelice, R. 2012. Social Media Dominates Smartphone Internet Time, Accounting for Almost One-Third of Minutes. GfK USA Research.
Can social support be harnessed for smoking cessation?
GoalPost is Melon Health’s smoking cessation program. It is a social media based smartphone app leveraging peer support, access to trained smoking cessation counsellors, motivational interviewing as well as other features such as tracking money saved and a panic button.
GoalPost has been validated as a user friendly and accessible tool. Since its beta launch in July 2012, more than 7000 users have utilized GoalPost and achieved a quit rate of 17%. The current average quit rates for the North American Quit Consortium and New Zealand Quitline (highest cessation rate of all Quitlines globally) are 4% and 12%, respectively. Majority of users have combined offline treatment (NRT, Chantix, etc) with the social network, persuasive technologies and expert advice provided through GoalPost.
Game mechanics may help motivate health behavior change
Status, achievements, ranks and reputation are some of the most commonly used mechanics in gamification. GoalPost incorporates these game mechanics to ‘hook’ the user and keep them motivated towards their goal.
Up to 12 weeks of abstinence from smoking is required for a former smoker’s brain receptor levels for nicotine to match those of nonsmokers (8). GoalPost is designed as a 12 week game to support people wanting to quit smoking during the first 12 weeks of abstinence. Developed in consultation with New Zealand’s Quitline, GoalPost sets tasks and challenges that have been proven to support smoking cessation.
GoalPost enables and encourages users to interact with the online peer community and track their progress in being smoke-free using their smartphones. Results from a pilot test of an SMS based mobile smoking cessation program found the feature for tracking cigarettes was the most used interactive feature, followed by a trivia game about nicotine cravings (9). We also shift current research paradigms by adding game mechanics. Points are awarded for completing tasks, as well as supporting others. These points are displayed on a leaderboard visible to all users.
#####(9) Abroms L. C., M. Ahuja, Y. Kodl, L. Thaweethai, J. Sims, J. P. Winickoff, R. A. Windsor. 2012. Text2Quit: Results From a Pilot Test of a Personalized, Interactive Mobile Health Smoking Cessation Program. Journal of Health Communication: International Perspectives 1:44-53.
We are still learning what works
GoalPost has allowed us to collect insightful data, such as quit rates and motivators – but we are still learning. The most popular task completed by users is “Write a post on why you want to quit smoking”. Ongoing use of the application will enable us to learn more and improve the program helping more people quit smoking for good.
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