Initial Evaluation of Acceptability, Engagement, and Effectiveness of the MoTm Smartphone App to Provide Comprehensive Support for Smoking Cessation: Development and Usability Study

Abstract Rationale The global nicotine addiction pandemic continues without a clearly accessible and validated solution. To address this issue, we piloted a user-centered design to iteratively develop a comprehensive mobile app (MOTM) with tailored and evidence-based content to support cigarette smokers on their journey. This study examined the acceptability, use, and preliminary efficacy of the MOTM app for smoking cessation by evaluating preferred features, engagement, potential improvements and evaluated its smoking cessation outcomes. Methods Through 3 cohorts, we recruited 10, 12, and 85 adult smokers who attempted to quit smoking to pilot-test the MOTM app between December 2019 and July 2022. Participants were instructed to complete a baseline survey, interact with the app for 6 weeks, and fill in a postsurvey at week 6. Participants in cohort 3 completed an additional postsurvey at week 12. Participants’ app use was tracked and analyzed and the primary outcome measures were participants’ 7-day point prevalence abstinence at 6 and 12 weeks. Results Participants reported high levels of satisfaction with the MOTM app across all 3 cohorts, rating it between 4.40 and 4.76 on a scale of 5 for acceptability. Users engaged with app activities for an average of 89 to 159 times over 35 days. The most liked features of the app included “quit plan,” “tracking,” “reminders and notifications,” “MOtalks,” and “motivational quotes.” The 7-day point prevalence abstinence rate of the modified intention to treat population in cohort 3 was 58% at 6 weeks and 52% at 12 weeks. Those who interacted more frequently with app features and engaged with more diverse activities were more likely to maintain abstinence at weeks 6 and 12. For each additional time logged into the app, the odds of staying abstinent at week 12 increased by 5% (odds ratio [OR] 1.05, 95% CI 1.01-1.08). Participants who earned > 5000 points during app use also had higher odds of quitting at both 6 weeks (OR 3.12, 95% CI 1.25-7.75) and 12 weeks (OR 4.65, 95% CI 1.83-11.76), compared with those who earned