Colorado School of Public Health, Aurora, CO, USA.
University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Health Promot Pract. 2021 Nov;22(6):850-862. doi: 10.1177/1524839920942214. Epub 2020 Jul 23.
One crucial factor that leads to disparities in smoking cessation between groups with higher and lower socioeconomic status is more prevalent socioenvironmental smoking cues in low-income communities. Little is known about how these cues influence socioeconomically disadvantaged smokers in real-world scenarios and how to design interventions, especially mobile phone-based interventions, to counteract the impacts of various types of smoking cues. We interviewed 15 current smokers living in low-income communities and scanned their neighborhoods to explore smoking-related experiences and identify multilevel cues that may trigger them to smoke. Findings suggest four major types of smoking cues influence low-income smokers-internal, habitual, social, and environmental. We propose an ecological model of smoking cues to inform the design of mobile health (mHealth) interventions for smoking cessation. We suggest that user-triggered strategies will be most useful to address internal cues; server-triggered strategies will be most suitable in changing perceived social norms of smoking and routine smoking activities to address social and habitual cues; and context-triggered strategies will be most effective for counteracting environmental cues. The pros and cons of each approach are discussed regarding their cost-effectiveness, the potential to provide personalized assistance, and scale.
导致社会经济地位较高和较低群体之间戒烟率存在差异的一个关键因素是，低收入社区中更普遍存在社会环境吸烟提示。对于这些提示如何在现实情况下影响社会经济处于不利地位的吸烟者，以及如何设计干预措施，特别是基于手机的干预措施来抵消各种类型的吸烟提示的影响，我们知之甚少。我们采访了 15 名居住在低收入社区的当前吸烟者，并扫描了他们的社区，以探讨与吸烟相关的体验，并确定可能促使他们吸烟的多层次提示。研究结果表明，有四种主要类型的吸烟提示会影响低收入吸烟者——内部、习惯性、社会和环境。我们提出了一个吸烟提示的生态模型，为基于移动健康 (mHealth) 的戒烟干预措施的设计提供信息。我们建议，用户触发策略对于解决内部提示最有用；服务器触发策略最适合改变对吸烟的社会规范和日常吸烟活动，以解决社会和习惯性提示；而上下文触发策略对于对抗环境提示最有效。针对每种方法的成本效益、提供个性化帮助的潜力和规模，讨论了每种方法的优缺点。
