1. Personalized prevention: mobile application for smokers
Pr Jean-François ETTER, PhD
Institute of Global Health
Personalized Health in the Digital Age
Geneva, September 22, 2016

2. Stop-tabac mobile app, since 2012, iOS and Android

3. Stop-tabac app for smartphones
Currently 22’000 users per month
Expensive to develop, but marginal cost per user = 0
Supported by Tobacco Prevention Fund, Canton GE
Available to users at no charge
Content:
Timely feedback if relapse, craving episode
Interactive ‘coach’ with individually-tailored messages
Discussion forum, moderated by psychologist and 15 voluntary moderators
Randomized trial ongoing, real vs ‘placebo’ app

4. Timely feedback if craving episode, withdrawal symptoms, or relapse
Ecological momentary assessment
Craving episode
Withdrawal symptoms: mood disturbance
Relapse
Timely, situational feedback (fact sheets)
Encouragement from “The Tribe”

5. Interactive ‘Coach’, individually-tailored feedback
Questionnaire: personal profile - current / former smoker - Quit date (planned or past) - Level of dependence (cigarettes per day) - Use of nicotine medications
Individually-tailored feedback report
Individually-tailored follow-up messages over several months

6. Discussion forum: “The Tribe”
Every month: - 5’400 messages are published - 51’000 responses to messages - 540’000 accesses to “The Tribe”
Response from other users usually in the next 2-3 minutes
Support, encouragement - from other users - from the psychologist
Moderation: - psychologist (University diploma in tobacco dependence treatment) - team of 15 moderators (volunteers), - from 7 am to 11 pm, daily

7. Efficacy: randomized controlled trial
Random assignment to app versus ‘placebo’ app
Follow-up by after 3 and 6 months
Outcome: self-report of smoking cessation and relapse
University of Bern
Funded by the Tobacco Prevention Fund (OFSP)
Already 1’700 participants (September 2016)
Follow-up rates - 40% after 3 months - 25% after 6 months

8. Impact = participation * efficacy
Conclusions
Impact = participation * efficacy
Small efficacy (2% above ‘placebo’ app?) but
Large, global enrollment: ’000 users since retention: 21% after 1 month
App should be integrated in medical care: - participants are encouraged to see Dr, addresses provided - app should be prescribed by physicians - patients should use of the app between medical visits
Future developments: - develop social network - improve compliance with medications