A cognitive dissonance-based mobile app intervention for smoking cessation: A single-arm pilot trial.

INTRODUCTION: Despite overall declines in the rate of tobacco use in the United States over the past 30 years, nearly 38 million Americans still smoke, posing extremely high risk for long-term health problems and death. Recent reviews note that there has been significant progress in the application of both clinical and public health interventions to help smokers quit; however, they have also concluded that the overall success rate has not significantly improved. There remains a need for novel, theory-driven approaches to enhance quit rates and innovative interventions that increase reach and engagement. In the current pilot study, we evaluated the use of a cognitive dissonance intervention for smoking cessation that was delivered via a mobile app. METHODS: The Support2Quit app was evaluated in a single arm pilot study with 72 adult daily smokers who were assessed at baseline, 1 month and 3 months. Feasibility, usability, participant satisfaction, and intervention outcomes were evaluated. RESULTS: The evaluation demonstrated promise that the Support2Quit app could effectively invoke significant increases in cognitive dissonance (average effect r=0.55; a large effect) and significant increases in readiness to quit smoking (average effect r=0.36; a medium effect). Outcomes showed a decrease in the number of cigarettes smoked each day for 41 (72%) of this sample; the non-parametric Wilcoxen signed-rank test showed an overall decrease in the number of cigarettes smoked per day from pretest to posttest (Z-score= -5.64, asymptotic p<0.001). User satisfaction ratings using a 5-point Likert scale indicated that the majority of 87.5% of participants reported liking the app (mean=3.7; SD=1.0) and that 82.5% reported that the app was helpful in reducing or stopping using cigarettes (mean=3.3; SD=1.0). CONCLUSIONS: Outcomes suggest that the Support2Quit mobile app was effective at inducing cognitive dissonance and might be a useful tool for reducing or quitting the use of cigarettes.