title: How Smart are Smartphone Apps for Smoking Cessation? A Content Analysis.
abstract: BACKGROUND
  Smartphone technology is ideally suited to provide tailored smoking cessation support, yet it is unclear to what extent currently existing smartphone "apps" use tailoring, and if tailoring is related to app popularity and user-rated quality.
  
  
  METHODS
  We conducted a content analysis of Android smoking cessation apps (n = 225), downloaded between October 1, 2013 to May 31, 2014. We recorded app popularity (>10,000 downloads) and user-rated quality (number of stars) from Google Play, and coded the existence of tailoring features in the apps within the context of using the 5As ("ask," "advise," "assess," "assist," and "arrange follow-up"), as recommended by national clinical practice guidelines.
  
  
  RESULTS
  Apps largely provided simplistic tools (eg, calculators, trackers), and used tailoring sparingly: on average, apps addressed 2.1 ± 0.9 of the 5As and used tailoring for 0.7 ± 0.9 of the 5As. Tailoring was positively related to app popularity and user-rated quality: apps that used two-way interactions (odds ratio [OR] = 5.56 [2.45-12.62]), proactive alerts (OR = 3.80 [1.54-9.38]), responsiveness to quit status (OR = 5.28 [2.18-12.79]), addressed more of the 5As (OR = 1.53 [1.10-2.14]), used tailoring for more As (OR = 1.67 [1.21-2.30]), and/or used more ways of tailoring 5As content (OR = 1.35 [1.13-1.62]) were more likely to be frequently downloaded. Higher star ratings were associated with a higher number of 5As addressed (b = 0.16 [0.03-0.30]), a higher number of 5As with any level of tailoring (b = 0.14 [0.01-0.27]), and a higher number of ways of tailoring 5As content (b = 0.08 [0.002-0.15]).
  
  
  CONCLUSIONS
  Publically available smartphone smoking cessation apps are not particularly "smart": they commonly fall short of providing tailored feedback, despite users' preference for these features.
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA; bhoeppner@mgh.harvard.edu.
authors.forename: Bettina B
authors.initials: BB
authors.lastname: Hoeppner
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA;
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Hoeppner
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA; Department of Psychology, Suffolk University, Boston, MA;
authors.forename: Lourah
authors.initials: L
authors.lastname: Seaboyer
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA;
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Schick
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA; School of Education, Johns Hopkins University, Baltimore, MD.
authors.forename: Gwyneth W Y
authors.initials: GW
authors.lastname: Wu
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA;
authors.forename: Brandon G
authors.initials: BG
authors.lastname: Bergman
authors.affiliation: Center for Addiction Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA;
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
mesh_terms: D006801:Humans; D063731:Mobile Applications; D000068997:Smartphone; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention