Limitations and Strengths
RECRUITMENT
The findings from this work must be viewed in the context of the study limitations. Chief among these is the small sample size; the study was not powered to detect minimal clinically meaningful differences with statistical significance, and the sample size limits our ability to draw any firm conclusions about the generalizability of the findings, particularly with regard to smoking behavior change. Additionally, cessation outcomes are based on self-reported data and are subject to social desirability bias. However, biochemical confirmation is not generally recommended in trials with no face-to-face contact and where the demand characteristics to misreport abstinence are low [To our knowledge, this is the first app to have been designed specifically for smokers who are ambivalent about quitting, thus addressing an important intervention gap. Other strengths include the recruitment of a high-risk and low–socioeconomic status sample, a rigorous methodological design that allows the unique effects of the experiments to be tested, reliance on both self-report and automated tracking data for outcomes, and overall strong follow-up participation at 3 months (47/57, 82.5%).