title: Using a Mobile App to Promote Smoking Cessation in Hospitalized Patients.
abstract: BACKGROUND
  The potential of interactive health education for preventive health applications has been widely demonstrated. However, use of mobile apps to promote smoking cessation in hospitalized patients has not been systematically assessed.
  
  
  OBJECTIVE
  This study was conducted to assess the feasibility of using a mobile app for the hazards of smoking education delivered via touch screen tablets to hospitalized smokers.
  
  
  METHODS
  Fifty-five consecutive hospitalized smokers were recruited. Patient sociodemographics and smoking history was collected at baseline. The impact of the mobile app was assessed by measuring cognitive and behavioral factors shown to promote smoking cessation before and after the mobile app use including hazards of smoking knowledge score (KS), smoking attitudes, and stages of change.
  
  
  RESULTS
  After the mobile app use, mean KS increased from 27(3) to 31(3) ( P<0.0001). Proportion of patients who felt they "cannot quit smoking" reduced from 36% (20/55) to 18% (10/55) ( P<0.03). Overall, 13% (7/55) of patients moved toward a more advanced stage of change with the proportion of patients in the preparation stage increased from 40% (22/55) to 51% (28/55). Multivariate regression analysis demonstrated that knowledge gains and mobile app acceptance did not depend on age, gender, race, computer skills, income, or education level. The main factors affecting knowledge gain were initial knowledge level ( P<0.02), employment status ( P<0.05), and high app acceptance ( P<0.01). Knowledge gain was the main predictor of more favorable attitudes toward the mobile app (odds ratio (OR)=4.8; 95% confidence interval (CI) (1.1, 20.0)). Attitudinal surveys and qualitative interviews identified high acceptance of the mobile app by hospitalized smokers. Over 92% (51/55) of the study participants recommended the app for use by other hospitalized smokers and 98% (54/55) of the patients were willing to use such an app in the future.
  
  
  CONCLUSIONS
  Our results suggest that a mobile app promoting smoking cessation is well accepted by hospitalized smokers. The app can be used for interactive patient education and counseling during hospital stays. Development and evaluation of mobile apps engaging patients in their care during hospital stays is warranted.
authors.affiliation: Columbia University, Department of Biomedical Informatics, New York, NY, United States. jf193@cumc.columbia.edu.
authors.forename: Joseph
authors.identifier: http://orcid.org/0000-0002-8084-7441
authors.initials: J
authors.lastname: Finkelstein
authors.forename: Eun Me
authors.identifier: http://orcid.org/0000-0003-0609-600X
authors.initials: EM
authors.lastname: Cha
keywords: health literacy; hospital; mobile apps; patient engagement; smoking cessation