Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers.

Background: Similar to adult smokers, quit attempts among younger smokers almost inevitably result in relapse. Unlike adults, less is known about the process of relapse in this younger age group. A technology-based remote monitoring system may allow for detailed and accurate characterization of smoking and abstinence and would help to improve cessation strategies. Objectives: This study describes a mobile system that captures smoking using breath carbon monoxide (CO) and real-time self-reports of smoking behavior. Compliance, feasibility, acceptability, and accuracy of the system were measured during a quit attempt and subsequent monitoring period. Methods: The mobile application (My Mobile Monitor, M-3) combined breath CO with ecological momentary assessment, delivered via smartphone. Participants (N=16; 75% female) were daily smokers between the ages of 19 and 25, who used the app for 11days during which they agreed to make a quit attempt. Acceptability, compliance, and abstinence were measured. Results: Participants averaged 22.3 +/- 2.0years old and smoked an average of 13.0 +/- 6.1 cigarettes per day. Overall session compliance was 69% and during the quit attempt, 56% of participants abstained from smoking for at least 24hours. Agreement between self-reported smoking compared to breath CO was generally high, when available for comparison, though underreporting of cigarettes was likely. Conclusion: This study demonstrates feasibility of a remote monitoring app with younger smokers, though improvements to promote compliance are needed. Remote monitoring to detect smoking and abstinence represents a step forward in the improvement of cessation strategies, but user experience and personalization are vital.