title: Prevalence and Frequency of mHealth and eHealth Use Among US and UK Smokers and Differences by Motivation to Quit.
abstract: BACKGROUND
  Both mHealth and eHealth interventions for smoking cessation are rapidly being developed and tested. There are no data on use of mHealth and eHealth technologies by smokers in general or by smokers who are not motivated to quit smoking.
  
  
  OBJECTIVE
  The aims of our study were to (1) assess technology use (eg, texting, social media, Internet) among smokers in the United States and United Kingdom, (2) examine whether technology use differs between smokers who are motivated to quit and smokers who are not motivated to quit, (3) examine previous use of technology to assist with smoking cessation, and (4) examine future intentions to use technology to assist with smoking cessation.
  
  
  METHODS
  Participants were 1000 adult smokers (54.90%, 549/1000 female; mean age 43.9, SD 15.5 years; US: n=500, UK: n=500) who were recruited via online representative sampling strategies. Data were collected online and included demographics, smoking history, and frequency and patterns of technology use.
  
  
  RESULTS
  Among smokers in general, there was a high prevalence of mobile and smartphone ownership, sending and receiving texts, downloading and using apps, using Facebook, and visiting health-related websites. Smokers who were unmotivated to quit were significantly less likely to own a smartphone or handheld device that connects to the Internet than smokers motivated to quit. There was a significantly lower prevalence of sending text messages among US smokers unmotivated to quit (78.2%, 179/229) versus smokers motivated to quit (95.0%, 229/241), but no significant differences between the UK groups (motivated: 96.4%, 239/248; unmotivated: 94.9%, 223/235). Smokers unmotivated to quit in both countries were significantly less likely to use a handheld device to read email, play games, browse the Web, or visit health-related websites versus smokers motivated to quit. US smokers had a high prevalence of app downloads regardless of motivation to quit, but UK smokers who were motivated to quit had greater prevalence of app downloads than smokers unmotivated to quit. US smokers were significantly more likely to have a Facebook account (87.0%, 435/500) than UK smokers (76.4%, 382/500), but smokers unmotivated to quit in both countries used Facebook less frequently than smokers motivated to quit. Smokers who were unmotivated to quit were less likely to have used eHealth or mHealth platforms to help them quit smoking in the past and less likely to say that they would use them for smoking cessation in the future.
  
  
  CONCLUSIONS
  Although smokers unmotivated to quit make less use of technology than smokers motivated to quit, there is sufficient prevalence to make it worthwhile to develop eHealth and mHealth interventions to encourage cessation. Short and low-effort communications, such as text messaging, might be better for smokers who are less motivated to quit. Multiple channels may be required to reach unmotivated smokers.
authors.affiliation: Boston University, Henry M Goldman School of Dental Medicine, Boston, MA, United States. belindab@bu.edu.
authors.forename: Belinda
authors.identifier: http://orcid.org/0000-0002-0859-796X
authors.initials: B
authors.lastname: Borrelli
authors.forename: Yvonne Kiera
authors.identifier: http://orcid.org/0000-0002-5913-3014
authors.initials: YK
authors.lastname: Bartlett
authors.forename: Erin
authors.identifier: http://orcid.org/0000-0003-0580-9813
authors.initials: E
authors.lastname: Tooley
authors.forename: Christopher J
authors.identifier: http://orcid.org/0000-0003-2365-1765
authors.initials: CJ
authors.lastname: Armitage
authors.forename: Alison
authors.identifier: http://orcid.org/0000-0001-6074-6275
authors.initials: A
authors.lastname: Wearden
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D009042:Motivation; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology* / Q000706:statistics & numerical data; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data; D060145:Text Messaging; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: eHealth; health behavior; mHealth; motivation; smoking cessation; text messaging