title: Who Uses Smoking Cessation Apps? A Feasibility Study Across Three Countries via Smartphones.
abstract: BACKGROUND
  Smartphone use is growing worldwide. While hundreds of smoking cessation apps are currently available in the app stores, there is no information about who uses them. Smartphones also offer potential as a research tool, but this has not previously been explored.
  
  
  OBJECTIVE
  This study aims to measure and compare the uptake of a smoking cessation app over one year in Australia, the United Kingdom, and the United States. It also assesses the feasibility of conducting research via an app, describing respondents' characteristics (demographics, smoking status, and other health related app use), and examining differences across countries.
  
  
  METHODS
  This is a cross-sectional exploratory study of adults 18 years and older, passively recruited over one year in 2012, who downloaded this study app (Quit Advisor) via the two largest app stores (Apple and Android).
  
  
  RESULTS
  The total number of app downloads after one year was 1751, 72.98% (1278/1751) of them were Apple operation system users. Of these 1751 participants, 47.68% (835/1751) were from the United States, 29.18% (511/1751) were from the United Kingdom, and 16.68% (292/1751) were from Australia. There were 602 participants, 36.75% (602/1638) that completed a questionnaire within the app. Of these 602 participants, 58.8% (354/602) were female and the mean age was 32 years. There were no significant differences between countries in terms of age, operation system used, number of quitting attempts, and language spoken at home. However, there were significant differences between countries in terms of gender and stage of change. There were 77.2% (465/602) of the respondents that were ready to quit in the next 30 days and the majority of these had never sought professional help (eg, "Quitline"). More than half had downloaded smoking cessation apps in the past and of these, three-quarters had made quitting attempts (lasted at least 24 hours) using an app before. Respondents who had attempted to quit three times or more in the previous year were more likely to have tried smoking cessation apps (OR 3.3, 95% CI 2.1-5.2). There were 50.2% (302/602) of the respondents that had used other health related apps before. Of these, 89.4% (270/302) were using health related apps at least once a week, but 77.5% (234/302) never checked the credibility of the health app publishers before downloading.
  
  
  CONCLUSIONS
  A smartphone app was able to reach smokers across three countries that were not seeking professional help, but were ready to quit within the next 30 days. Respondents were relatively young and almost demographically similar across all three countries. They also frequently used other health related apps, mostly without checking the credibility of their publishers.
authors.affiliation: Sydney Medical School, Department of Public Health, University of Sydney, Sydney, Australia. nbin6641@uni.sydney.edu.au.
authors.forename: Nasser F
authors.identifier: http://orcid.org/0000-0001-8117-1044
authors.initials: NF
authors.lastname: BinDhim
authors.forename: Kevin
authors.initials: K
authors.lastname: McGeechan
authors.forename: Lyndal
authors.initials: L
authors.lastname: Trevena
keywords: apps; global health; handheld computers; health Informatics; health promotion; prevention; public health; smartphone; tobacco and smoking
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