Quit Sense App.
smoking behavior, mood,Stage 2
Quit Sense arm participants also received an automated text message providing a link to the Quit Sense app on the Google Play store, along with a unique activation code. If the app had not been installed after 3 days, participants were sent a reminder text message to encourage installation. Five days later, if still not installed, a further text message was sent inviting participants to reply by selecting one of the five pre-specified reasons for not having installed the app.Quit Sense, a context-aware Just-In-Time Adaptive Intervention (JITAI), is informed by learning theory and two theory-guided SMS text message systems,A central feature is “Geofence-Triggered Support” (GTS), which is orientated around three stages within the app:Stage 1 (“train the app”): Using a real-time smoking reporting tool, the user trains the app to learn about their smoking behavior until their quit date arrives. Users are asked to report smoking using this tool each time they smoke. For each report, the user indicates the situational context when they “light up” (stress, mood,Stage 2 (“commit to quit” – a 28-day abstinence challenge): After their quit date has passed, the app monitors the user’s location. If they enter and remain in (≥5 minutes) a smoking geofence, the app will determine whether to trigger a GTS message, based on smoking reporting history (using frequency thresholds) and time of day, for that location. GTS messages are tailored to the situation and many are also tailored using the context information from the smoking reports. GTS messages provide lapse prevention support to help manage or avoid potential cue-induced cravings. Further decisions about whether to trigger messages are made after each 3-hour interval of remaining in that location (default between 8:00 AM and 9:30 PM or defined by the user). New geofences are created if lapses are reported, as with stage 1.Stage 3 (“maintain the change”): The app continues to deliver GTS for 2 further months but reduces the frequency by one-half every month. After 3 months post-quit date, the GTS support stops, unless the user opts to restart their quit attempt, which they can do at any time.Quit Sense had additional features, relevant to all stages unless specified (for details see protocolAn End of Day survey with feedback messages after completion.A “my profile” section providing days quit and money saved, a self-monitoring calendar showing emoji feedback for smoking, cravings, and self-efficacy for each end-of-day survey and smoking pattern graphical and written feedback for reported smoking triggers.A library of cessation advice messages across key topics.Scheduled morning daily support messages oriented around the quit date.Quit date reset option, either manually triggered or offered if relapse (more than one smoking episode reported each day over 2 consecutive days) is determined.