Heffner Jaimee L, Mull Kristin E
Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, United States.
J Med Internet Res. 2017 Aug 31;19(8):e305. doi: 10.2196/jmir.7953.
Despite increasing interest in smartphone apps as a platform for delivery of tobacco cessation interventions, no previous studies have evaluated the prevalence and characteristics of smokers who can access smartphone-delivered interventions.
To guide treatment development in this new platform and to evaluate disparities in access to smartphone-delivered interventions, we examined associations of smartphone ownership with demographics, tobacco use and thoughts about quitting, other health behaviors, physical and mental health, health care access, and Internet and technology utilization using a nationally representative sample of US adult smokers.
Data were from the National Cancer Institute's 2014 Health Information National Trends Survey 4 (HINTS 4), Cycle 4. This mailed survey targeted noninstitutionalized individuals aged 18 years or older using two-stage stratified random sampling. For this analysis, we restricted the sample to current smokers with complete data on smartphone ownership (n=479).
Nearly two-thirds (weighted percent=63.8%, 248/479) of smokers reported owning a smartphone. Those who were younger (P<.001), employed (P=.002), never married (P=.002), and had higher education (P=.002) and income (P<.001) had the highest rates of ownership. Smartphone owners did not differ from nonowners on frequency of smoking, recent quit attempts, or future plans to quit smoking, although they reported greater belief in the benefits of quitting (P=.04). Despite being equally likely to be overweight or obese, smartphone owners reported greater fruit and vegetable consumption (P=.03) and were more likely to report past-year efforts to increase exercise (P=.001) and to lose weight (P=.02). No differences in health care access and utilization were found. Smartphone owners reported better physical and mental health in several domains and higher access to and utilization of technology and the Internet, including for health reasons.
Smartphone ownership among smokers mirrors many trends in the general population, including the overall rate of ownership and the association with younger age and higher socioeconomic status. Apps for smoking cessation could potentially capitalize on smartphone owners' efforts at multiple health behavior changes and interest in communicating with health care providers via technology. These data also highlight the importance of accessible treatment options for smokers without smartphones in order to reach smokers with the highest physical and mental health burden and prevent worsening of tobacco-related health disparities as interventions move to digital platforms.
尽管人们对将智能手机应用程序作为提供戒烟干预措施的平台越来越感兴趣，但此前尚无研究评估能够获取通过智能手机提供的干预措施的吸烟者的患病率和特征。
为指导这一新平台的治疗方案开发，并评估获取通过智能手机提供的干预措施方面的差异，我们使用美国成年吸烟者的全国代表性样本，研究了智能手机拥有情况与人口统计学特征、烟草使用及戒烟想法、其他健康行为、身心健康、医疗保健获取情况以及互联网和技术使用情况之间的关联。
数据来自美国国家癌症研究所2014年健康信息全国趋势调查4（HINTS 4）第4轮。这项邮寄调查采用两阶段分层随机抽样，针对18岁及以上的非机构化个体。对于本分析，我们将样本限制为拥有智能手机完整数据的当前吸烟者（n = 479）。
近三分之二（加权百分比 = 63.8%，248/479）的吸烟者报告拥有智能手机。年龄较小（P <.001）、就业（P =.002）、从未结婚（P =.002）、受过高等教育（P =.002）和收入较高（P <.001）的吸烟者拥有智能手机的比例最高。智能手机拥有者与非拥有者在吸烟频率、近期戒烟尝试或未来戒烟计划方面没有差异，不过他们报告对戒烟益处的信念更强（P =.04）。尽管超重或肥胖的可能性相同，但智能手机拥有者报告的水果和蔬菜摄入量更多（P =.03），并且更有可能报告过去一年为增加运动量（P =.001）和减肥（P =.02）所做的努力。在医疗保健获取和使用方面未发现差异。智能手机拥有者在几个领域报告的身心健康状况更好，并且对技术和互联网的获取和使用更多，包括出于健康原因。
吸烟者中的智能手机拥有情况反映了一般人群中的许多趋势，包括总体拥有率以及与年轻年龄和较高社会经济地位的关联。戒烟应用程序有可能利用智能手机拥有者在多种健康行为改变方面所做的努力以及他们通过技术与医疗保健提供者沟通的兴趣。这些数据还凸显了为没有智能手机的吸烟者提供可及治疗选择的重要性，以便接触到身心健康负担最重的吸烟者，并防止随着干预措施转向数字平台，与烟草相关的健康差距进一步扩大。
