title: Design Considerations for Smoking Cessation Apps: Feedback From Nicotine Dependence Treatment Providers and Smokers.
abstract: BACKGROUND
  Hundreds of smoking cessation apps are commercially available, but most are not theory-based or designed to take advantage of mobile technology in ways that could make them more engaging and possibly more effective. Considering input from both clinical experts (who understand best practice nicotine dependence treatment requirements) to inform appropriate content and from smokers (the end users) to express their preferences is important in designing these programs in the future.
  
  
  OBJECTIVE
  To assess and compare the opinions of nicotine dependence treatment providers and smokers regarding the design of future smoking cessation apps.
  
  
  METHODS
  We surveyed providers (n=264) and smokers who own smartphones (n=40) to assess their opinions on the importance of 21 app design features. Features represented 5 domains: cost, reputation, privacy and security, content and user experience, and communication. Domains were chosen to reflect best practice treatment, leverage mobile technology to support smoking cessation, and elicit important user preferences. Data were collected between June and July 2015.
  
  
  RESULTS
  Most providers agreed that mHealth apps hold promise for helping people quit smoking (203/264, 76.9%) and would recommend them to their clients/patients (201/264, 76.1%), especially if the app were empirically validated (236/264, 89.4%). Few providers believe effective cessation apps currently exist (112/264, 42.4%). Few smokers (5/40, 13%) had ever downloaded a smoking cessation app; of the ones who had not, most said they would consider doing so (29/35, 83%). Both respondent groups indicated the following features were very to extremely important to include in cessation apps: free or low cost, keeps information private, matches individual needs and interests, adapts as one's needs and interests change, helps to manage nicotine withdrawal symptoms and medication side effects, and allows users to track their progress. Providers and smokers also indicated gaming and social media connectivity were less important than other features. Despite these similarities, the groups had significantly different opinions about the relative importance of various features. In particular, providers rated privacy as the most important feature, whereas smokers rated low cost and the ability to adaptively tailor content as the most important features.
  
  
  CONCLUSIONS
  Smoking cessation apps hold great promise as intervention tools but only if they engage users and appropriately treat nicotine dependence. Intervention development should take into consideration the perspectives of both treatment experts and smokers. This paper highlights important perspectives from each of these groups to be considered when designing future app-based smoking cessation programs.
authors.affiliation: Group Health Research Institute, Seattle, WA, United States. McClure.J@ghc.org.
authors.forename: Jennifer B
authors.identifier: http://orcid.org/0000-0002-2094-9147
authors.initials: JB
authors.lastname: McClure
authors.forename: Andrea L
authors.identifier: http://orcid.org/0000-0003-4932-7314
authors.initials: AL
authors.lastname: Hartzler
authors.forename: Sheryl L
authors.identifier: http://orcid.org/0000-0002-6325-9349
authors.initials: SL
authors.lastname: Catz
keywords: mobile health; smartphone; smoking; tobacco use cessation