1. 1 Development of SF28: a smartphone application to aid smoking cessation University College London November 2012 Robert West

2. How to stop smoking Decide on the ‘quit smoking rule’ Decide on the ‘quit point’ Lay the ground work Get ready Apply the quit smoking rule Go Do whatever is necessary stick to the rule Keep going 2

3. PRIME Theory 3 West 2005 Theory of Addiction To stay off cigarettes the resolve not to smoke must remain higher than the impulse to smoke at all times when a cigarette is available

4. The battle of will ‘in the moment’ I will not  will smoke Smoking would be bad  good Want/need to not smoke  smoke Want/need to not smoke  smoke Inhibition/urge not smoke  smoke Inhibition/urge not smoke  smoke

5. The battle over time and where interventions fit it 5 Time Intervention

6. Automated support Websites Text messaging Smartphone apps 6

7. Smoking cessation websites 7 Civljak 2010 Cochrane Reviews

8. Industry-sponsored sites 8 Based on Click2Quit Based on Happy Endings

9. StopAdvisor 9

10. Text2Stop 10

11. SF28 11

12. Design principles Maintain complete abstinence for 28 days during which urges to smoke are strongest – launch pad for long-term abstinence Top level framework –goal setting, monitoring and feedback –tools needed to achieve the goal motivational self-regulatory facilitatory –strong emphasis on attractive design 12

13. SF28 in practice 13 Clear target and feedback on progress Additional reward: cost calculator Toolbox

14. Toolbix advice on adapting lifestyle to minimise exposure to smoking cues and maximising ego-strength Lifestyle motivational messages from smokers video clips of smokers who are at the same stage who went on to succeed Inspiration Advice on dealing with cravings Distraction game Craving advice on use of stop-smoking medicines Medication 14

15. Preliminary evaluation of use and users Available free on iTunes Data collected automatically from users Cleaned to remove ‘window shoppers’ and people testing the app Information collected on –Socio-demographic characteristics –Smoking characteristics –Usage –Smoking Data presented on first 183 smokers who had passed the 28 day point 15

16. Characteristics of SF28 users 16

17. Characteristics of SF28 users 17

18. Reported usage and outcomes 18

19. Conclusions Smartphone apps have the potential to deliver BCTs to boost resolve and minimise urges to smoke when needed SF28 aims to apply theoretically-based principles to achieve this suing a design that is attractive and easy to use Data suggest that it has some value and are being used to develop the product Next steps include qualitative evaluation, followed by pilot RCT 19