Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 11;8(6):e19494.
doi: 10.2196/19494.

Influence of the SARS-CoV-2 Outbreak on the Uptake of a Popular Smoking Cessation App in UK Smokers: Interrupted Time Series Analysis

Olga Perski  1 , Aleksandra Herbeć  1   2 , Lion Shahab  1 , Jamie Brown  1
Affiliations

Influence of the SARS-CoV-2 Outbreak on the Uptake of a Popular Smoking Cessation App in UK Smokers: Interrupted Time Series Analysis

Olga Perski et al. JMIR Mhealth Uhealth. .

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out mobile health support, such as smartphone apps.

Objective: We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free.

Methods: Data were from daily and nondaily adult smokers in the United Kingdom who had downloaded the Smoke Free app between January 1, 2020, and March 31, 2020 (primary analysis), and January 1, 2019, and March 31, 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalized as March 1, 2020 (primary analysis), and January 15, 2020 (secondary analysis). Generalized additive mixed models adjusted for relevant covariates were fitted.

Results: Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. Calculation of Bayes factors (BFs) indicated that the data for the primary analysis favored the null hypothesis compared with large associations (for level, BF=0.25; for slope, BF=0.26) but were insensitive to the detection of small associations (for level, BF=0.78; for slope, BF=1.35).

Conclusions: In the United Kingdom, between January 1, 2020, and March 31, 2020, and between January 1, 2019, and March 31, 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a large step change or increasing trend in downloads of a popular smoking cessation app. Findings on the association of the SARS-CoV-2 outbreak with a small step change or increasing trend were inconclusive.

Keywords: COVID-19; SARS-CoV-2; app; mobile health; public health; smartphone app; smoking; smoking cessation; time series analysis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: OP and JB are unpaid members of the scientific advisory committee for the Smoke Free app. LS has received a research grant and honoraria for a talk and travel expenses from manufacturers of smoking cessation medications (Pfizer and Johnson & Johnson). JB and AH have received unrestricted research funding from Pfizer to study smoking cessation.

Figures

Figure 1
Figure 1
The number of users downloading the Smoke Free app from January 1, 2020, to March 31, 2020. The dotted blue vertical line represents the stipulated starting point of the severe acute respiratory syndrome coronavirus 2 outbreak (ie, March 1, 2020). The solid red line represents the fitted values with a loess smoothing function applied and associated 95% CIs.
Figure 2
Figure 2
The number of users downloading the Smoke Free app from January 1, 2019, to March 31, 2020. The dotted blue vertical line represents the stipulated starting point of the severe acute respiratory syndrome coronavirus 2 outbreak (ie, January 15, 2020). The solid red line represents the fitted values with a loess smoothing function applied and associated 95% CIs. For clarity, the y-axis was capped at 1300 downloads.
See this image and copyright information in PMC

References

    1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Liu M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JT, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020 Mar 26;382(13):1199–1207. doi: 10.1056/NEJMoa2001316. http://europepmc.org/abstract/MED/31995857 - DOI - PMC - PubMed
    1. Ball T, Wace C, Smyth C, Brown D. The Times. 2020. Jan 31, Hunt for contacts of coronavirus-stricken pair in York http://web.archive.org/web/20200415110133/https://www.thetimes.co.uk/art....
    1. Department of Health and Social Care. 2020. Jan 24, [2020-03-31]. Number of coronavirus (COVID-19) cases and risk in the UK http://web.archive.org/web/20200415110345/https://www.gov.uk/guidance/co....
    1. Department of Health and Social Care. 2020. Mar 03, Coronavirus (COVID-19) action plan https://www.gov.uk/government/publications/coronavirus-action-plan.
    1. Cox S. BMJ Opinion. 2020. Mar 20, Risky smoking practices and the coronavirus: a deadly mix for our most vulnerable smokers http://web.archive.org/web/20200415110539/https://blogs.bmj.com/bmj/2020...

Publication types