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Acceptability of a carbon monoxide monitoring feature of a smoking cessation mobile application: a virtual focus
Lydia Tesfaye1, Michael Wakeman1, Gunnar Baskin2
1Division of Intramural Research, National Institute on Minority Health and Health Disparities, Rockville, Maryland, USA.
Introduction:
Monitoring exhaled carbon monoxide (CO), a physiological measure of cigarette smoking, can aid cessation. Following a multiphase optimisation strategy for intervention development and evaluation, we gauged the acceptability of CO monitoring using the iCOquit Smokerlyzer as an intervention component of a mobile cessation app, Quit Journey, targeting individuals with low socioeconomic status who smoke.
Methods:
We conducted 12 virtual focus groups with 38 current cigarette smokers who were 18-29 years old and were neither currently enrolled in a 4-year college nor had a 4-year college degree. Using deductive thematic analysis, we coded the transcripts based on constructs from the Second Unified Theory of Acceptance and Use of Technology (ie, performance expectancy, effort expectancy, facilitating conditions, hedonic motivation, social influence) and sentiment (ie, negative, neutral, positive).
Results:
The top themes were performance expectancy (n=53 quotes, 35.33%), effort expectancy (n=39 quotes, 26.00%) and facilitating conditions (n=20 quotes, 13.33%), where 56.66% of the quotes (n=85) reflected a positive sentiment. CO monitoring was perceived as useful owing to the affordances for tracking progress using an objective metric. While deemed easy to use, concerns emerged related to difficulties in interpreting CO test results. Lack of awareness of CO monitors and their cost was the primary issue under the theme of facilitating conditions. Improvements to the CO monitoring feature centred on providing detailed information on how to use the CO monitor, testing procedure and test values.
Conclusions:
Exhaled CO monitoring was deemed an acceptable intervention component of Quit Journey. Ensuring the affordability of CO monitors and educating people on CO monitoring would improve their acceptance among people who smoke. CO monitoring could potentially improve the efficacy of mobile interventions, particularly among those disproportionately affected by smoking.
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