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A smartphone app providing financial incentives for smoking cessation based on exhaled carbon monoxide (CO) levels is feasible and acceptable for hospitalized patients. Track 3, offering incentives only for CO levels below 10 ppm, showed the highest engagement and abstinence rates.

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Area of Science:

  • Digital Health
  • Behavioral Science
  • Public Health

Background:

  • Hospitalization presents a key opportunity for tobacco treatment engagement among underserved populations.
  • Post-discharge interventions are crucial for sustained smoking cessation but often underutilized.
  • Financial incentives can motivate individuals to initiate and maintain smoking abstinence.

Purpose of the Study:

  • To assess the feasibility and acceptability of a novel smartphone-based financial incentive program for smoking cessation.
  • The intervention targets hospitalized smokers, utilizing exhaled carbon monoxide (CO) monitoring post-discharge.

Main Methods:

  • A pilot study involved 33 hospitalized smokers using a tailored mobile application with facial recognition and a portable CO monitor.
  • Participants received financial incentives via digital wallet, with three tracks varying incentive contingency based on CO levels (<10 ppm).
  • Twice-daily CO tests were conducted for 30 days post-discharge, with feasibility and acceptability measured quantitatively and qualitatively.

Main Results:

  • 76% of participants completed the program, and 61% tested CO levels weekly.
  • The highest engagement and in-treatment abstinence were observed in Track 3, where incentives were contingent on CO levels <10 ppm.
  • Participants reported high satisfaction and motivation for smoking cessation, suggesting longer program duration and added counseling.

Conclusions:

  • Smartphone-delivered financial incentives, linked to exhaled CO measurements, offer a feasible and acceptable approach to tobacco cessation.
  • Further research is recommended to evaluate the intervention's efficacy after incorporating counseling or text-messaging components.