A Mobile Computer‐Assisted Education System to Promote Smoking Cessation for Hospitalized Patients

Background:

Tobacco smoking is the leading preventable cause of death in the United States, Most interventions for hospitalized smokers have used some combination of physician advice to quit, behavioral counseling, and self‐help materials including booklets, audiotapes, and videotapes. Mobile communication technology has the advantage of being interactive and can be tailored to patients' preferred learning styles and disease experience; however, it has not previously been systematically assessed in the hospital setting.

Methods:

A previously developed curriculum about the hazards of smoking was adapted for use in the computer‐assisted education (CO‐ED) system. In the CO‐ED system, brief educational statements about the effects of smoking and the advantages of quitting are presented, each followed by a multiple–choice question about the material. When the correct answer is chosen, users are congratulated and directed to the next educational statement. When the question is answered incorrectly, users are given an opportunity to review the material and reattempt the question. For this pilot study, inpatients at 2 urban academic hospitals were screened for smoking status, and a sample of smokers was then approached to participate. Participants completed a set of questions about demographics, prior experience with mobile devices, and knowledge about the effects of smoking before and after using the system. A research assistant provided patients with a touch‐screen tablet PC and trained them how to use the self‐paced CO‐ED module. Patients spent up to 45 minutes using the system.

Results:

A convenience sample of 17 hospitalized smokers used CO‐ED. The mean age was 46 years, and 53% were women. The subjects had smoked an average of 13 ± 2.2 cigarettes per day for 24 ± 3.3 years. Although about 65% of the participants had never used a computer or had only basic skills, 91% reported that the mobile touch screen was not complicated at all. More than 90% responded that they gained a very significant amount of new informalion. A pre–post comparison demonstrated significant improvement in the Knowledge score, with an average increase of 3.5 ± 3.1 points (P = 0.002) of a possible 35 points. Before using the system, 47%, 29%, and 24% of the participants responded that they were thinking about quitting smoking within the next 30 days, thinking about quitting within the next 6 months, or not thinking about quitting, respectively. After using the system, 65% were ready to quit within 30 days, 18% were ready to quit within 6 months, and 18% were still not thinking about quitting.

Conclusions:

The mobile touch‐screen system is a feasible way to educate patients about the hazards of smoking. This system may also be effective in other chronic conditions where patients can benefit from self‐management of their illnesses. Further research is needed regarding the cost effectiveness and long‐term effects of this patient education method in the hospital setting.

Author Disclosure:

A. Knight, none; J. Finkelstein, none; E. Cha, none; D. Brotman, none.