Acceptability and Usability of Mobile Apps for Smoking in Young People in Community Mental Health Care

Young adults with severe mental illness (SMI) are more than twice as likely to have tobacco use disorder (TUD) than the general population, and while they report interest in quitting smoking, they are less likely to achieve abstinence. There is great need for scalable interventions for this group, but very little research has evaluated the efficacy of interventions among young adults with SMI and TUD. Over 70% of young adults with SMI own smartphones and are interested in using their phones for behavioral interventions, suggesting that smartphone apps may be an underutilized tool for treating tobacco use disorder. The National Cancer Institute (NCI) provides freely available smoking cessation apps which have scored better than most available apps on measures of content quality. However, no studies have assessed their usability, effectiveness, or appeal in young adults with SMI who have grown up in the era of smartphones, but who may be limited by mental-illness related cognitive impairments.

The goals of this pilot project will be to: 1) evaluate the content and design of the current versions of NCI’s smoking cessation apps with expert reviewers using current guidelines for evidence-based smoking cessation interventions and mobile apps; 2) identify facilitators and barriers to using mobile smoking cessation apps among young adults with TUD and SMI, and describe attitudes about using apps with clinical support in young adults with TUD and SMI; 3) assess usability, appeal, and feasibility of NCI’s smoking cessation apps among young adults with TUD and SMI within a laboratory observation protocol and during naturalistic, community use over a two-week period; and 4) create a clinician manual to guide NCI app use in future studies of TUD treatment interventions for young adults with SMI based on findings in Aims 1-3. The data generated in this pilot project will inform a larger study that will test a smoking cessation approach that includes digital health for young adults with SMI and TUD.