DEVELOPMENT AND USABILITY EVALUATION OF A SMOKING CESSATION APPLICATION USING COGNITIVE-BEHAVIORAL THERAPY (CBT) TECHNIQUES
Keywords:
smoking cessation; mobile applications; cognitive-behavioral therapy.Abstract
Smoking is a chronic disease caused by nicotine dependence and is a risk factor for several serious illnesses. The World Health Organization and the National Tobacco Control Program (PNCT) encourage the use of technologies to support smokers in cessation. This study aimed to develop and evaluate the usability of the "Sessão Não Fume PRO" app, designed for coordinators and users in tobacco control programs. It is an observational study with a quantitative and technological approach. The app was developed in React Native, with data storage in Firebase and gamification to promote patient engagement. The study sample included 17 participants: 9 PNCT users from a University Hospital and 8 coordinators. After one week of use, participants completed the System Usability Scale (SUS) questionnaire. Usability was rated at 80.31 among coordinators and 79.17 among users, classifying it as excellent. It is concluded that 'Sessão Não Fume PRO' is a promising tool to support smoking cessation, featuring a user-centered design and a scientific foundation based on Cognitive-Behavioral Therapy (CBT). The study reinforces the importance of technological strategies in smoking cessation, highlighting the need for continuous improvement to enhance its efficacy and accessibility.
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References
Andrade, L.P. (2017). Avaliação da usabilidade de um sistema de informação em saúde neonatal, através da percepção do usuário, utilizando a ferramenta System Usability Scale. Dissertação de Mestrado. Programa de Pós-Graduação em Gestão e Informática em Saúde, EPM, São Paulo, SP. https://repositorio.unifesp.br/items/30fc0d28-95de-4868-b615-4bcf332f58a4
Azevedo, R.C.S., Higa, C. M. H., Assumpção, I. S. M. A., Frazatto, C. R. G., Fernandes, R. F., Goulart, W., Botega, N. J., Boscolo, M. M. & Sartori, R. M. (2009).Grupo terapêutico para tabagistas: resultados após seguimento de dois anos. Revista da Associação Médica Brasileira, 55(5), 593-596. https://doi.org/10.1590/S0104-42302009000500025
Bangor, A.; Kortum, P. & Miller J. (2009). Determining what individual SUS scores mean: Adding an adjective rating scale. Journal of User Experience, 4(3), 114-23, 2009. https://uxpajournal.org/determining-what-individual-sus-scores-mean-adding-an-adjective-rating-scale/
Brooke, J. (1995). Sus-a quick and dirty usability scale. Usability Eval. Ind., 189, 4-7. https://www.researchgate.net/publication/228593520_SUS_A_quick_and_dirty_usability_scale
Brasil (2020). Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). https://cid10.com.br/
Brasil (2020). Protocolo Clínico e Diretrizes Terapêuticas do Tabagismo. Ministério da Saúde. https://farmaciacidada.es.gov.br/Media/farmaciacidada/Componente-Estrategico/Tabagismo/Protocolo%20Cl%C3%ADnico%20e%20Diretrizes%20Terap%C3%AAuticas%20do%20Tabagismo%20-%2003.2020.pdf
Brasil (2020). Portaria Conjunta nº 10, de 16 de abril de 2020. Aprova o Protocolo Clínico e Diretrizes Terapêuticas do Tabagismo. Disponível em: https://www.in.gov.br/en/web/dou/-/portaria-conjunta-n-10-de-16-de-abril-de-2020-253756566
Bricker, J. B., Copeland, W., Mull, K. E., Zeng, E.Y., Watson, N. L., Akioka, K.J. & Heffner, J. L. (2017). Single-arm trial of the second version of an acceptance & commitment therapy smartphone application for smoking cessation. Drug Alcohol Depend., 170, 37-42. https://pubmed.ncbi.nlm.nih.gov/27870987/
Campos, P. C. M. & Gomide M. (2015). O Programa Nacional de Controle do Tabagismo (PNCT) na perspectiva social: a análise de redes, capital e apoio social. Cadernos Saúde Coletiva, 23(4), 436-444. https://doi.org/10.1590/1414-462X201500040241
Cavalcanti, H. G. O., Bushatsky, M., Barros, M. B. S. C., Melo, C. M. C. S. & Delgado-Filho, A. J. F. (2021). Avaliação da usabilidade de um aplicativo móvel para detecção precoce do câncer pediátrico. Revista Gaúcha de Enfermagem, 42, 1-8. https://doi.org/10.1590/1983-1447.2021.20190384
Formagini, T. D. B., Ervilha, R. R., Machado, N. M., Andrade, B. A. B. B., Gomide, H. P. & Ronzani, T. M. (2017). Revisão dos aplicativos de smartphones para cessação do tabagismo disponíveis em língua portuguesa. Cadernos de Saúde Pública, 33(2), 1-11. https://doi.org/10.1590/0102-311X00178215
Hartmann-Boyce, J., Stead, L. F. & Lancaster T.. (2013). Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews. Addiction, 108, 1711-1721. https://doi.org/10.1111/add.12291
Haskins, B. L., Lesperance D. Gibbons, P. & Broundeaux, E. D. (2017). A systematic review of smartphone applications for smoking cessation. Translational Behavioral Medicine, 7(2), 292-299. https://pmc.ncbi.nlm.nih.gov/articles/PMC5526818/
Instituto Nacional de Câncer José Alencar Gomes da Silva. (2022). Tabagismo. Rio de Janeiro: INCA. https://www.gov.br/inca/pt-br/assuntos/causas-e-prevencao-do-cancer/tabagismo
Luna-Perejon, F., Malwade, S., Styliadis, C., Civit, J., Cascado-Caballero, D., Konstantinidis, E., Abdul, S. S., Bamidis, P. D., Civit, A., Li, Y. J. (2019). Evaluation of user satisfaction and usability of a mobile app for smoking cessation. Computer Methods and Programs in Biomedicine, 182, 1-16. https://doi.org/10.1016/j.cmpb.2019.105042
Mesquita, A. A. (2013). Avaliação de um programa de tabagismo. Revista Brasileira de Terapia Comportamental e Cognitiva, 15(2), 35-44. https://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1517-55452013000200004
Nielsen, J. (2012). Usability 101: Introduction to Usability. Nielsen Norman Group. https://www.nngroup.com/articles/usability-101-introduction-to-usability/
Padrini-Andrade, L., Balda, L. C. X., Areco, K. C. N., Bandiera-Paiva, P., Nunes, M. V., Marba, S. T. M., Carvalho, W. D., Rugolo, L. M. S. S., Almeida, J. H. C., Procianoy, R. S., Duarte, J. L. M. B., Rego, M. A., Ferreira, D. M. L. M., Filho, N. A., Guinsburga, R., Diniz, E. M. A., Santos, J. P. F., Testoni, D.,Silva, N. M. M., Gonzaleso, M. R. C., Silva, R. V. C., Meneses, J., Gonçalves-Ferrir, W. A., Perussi-e-silva, R., & Bomfim, O. (2019). Avaliação da usabilidade de um sistema de informação em saúde neonatal segundo a percepção do usuário. Revista Paulista de Pediatria, 37(1), 90-96. https://www.scielo.br/j/rpp/a/T5sJ3dTFcZJrxLhRv9XBQhM/?lang=en
Portes, L. H., Machado, C. V., Turci, S. R. B., Figueiredo, V. C., Cavalcante, T. M. & Silva, V. L. C. (2018). A Política de Controle do Tabaco no Brasil: um balanço de 30 anos. Ciência & Saúde Coletiva, 23(6), 1837-1848.
https://doi.org/10.1590/1413-81232018236.05202018
Rajani, N. B., Weth, D., Mastellos, N. & Filippidis, F. T. (2019). Adherence of popular smoking cessation mobile applications to evidence-based guidelines. BMC Public Health, 19(1), 1-8. https://pubmed.ncbi.nlm.nih.gov/31196062/
Sauro, J. & Lewis, J. R. (2012). Quantifying the user experience: Practical statistics for user research. Waltham, MA: Elsevier.
Seo, S., Cho, S., Yoon, W. &Lee, C. M.(2022). Classification of Smoking Cessation Apps: Quality Review and Content Analysis. JMIR mHealth and uHealth, 10(2), e17268. https://pmc.ncbi.nlm.nih.gov/articles/PMC8895289/
Silva, L. C. C., Araujo, A. J., Queiroz, A. M. D., Sales, M. P. U. & Castellano, M. V. C. O. (2016). Controle do tabagismo: desafios e conquistas. Jornal Brasileiro de Pneumologia, 42(4), 290-298. https://www.scielo.br/j/jbpneu/a/9ZRBLwC4JbRYGXb66krwjBC/abstract/?lang=pt
Stoddard, J., Augustson, E. M., & Mabry, P. L. (2006). The importance of usability testing in the development of an internet-based smoking cessation treatment resource. Nicotine and Tobacco Research, 8(1), s87-s93. https://pubmed.ncbi.nlm.nih.gov/17491175/
Ubhi, H. K., Michie, S., Kotz, D., Schayck, O. C. P., Selladurai, A. & West, R. (2016). Characterising smoking cessation smartphone applications in terms of behaviour change techniques, engagement and ease-of-use features. Translational Behavioral Medicine, 6(3), 410-417. https://doi.org/10.1007/s13142-015-0352-x
Whittaker, R., McRobbie, H., Bullen, Chris., Rodgers, A., Gu, Y., & Dobson, R. (2016). Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews, (4), CD006611. https://doi.org/10.1002/14651858.CD006611.pub4
Wittkowski, L., & Dias, C. R. S. (2017). Avaliação dos resultados obtidos nos grupos de controle do tabagismo realizados numa unidade de saúde de Curitiba-PR. Revista Brasileira de Medicina de Família e Comunidade, 12(39), 1-11. https://rbmfc.org.br/rbmfc/article/view/1463
World Health Organization. (2013). Ban tobacco advertising to protect young people. https://www.who.int/news/item/29-05-2013-ban-tobacco-advertising-to-protect-young-people
World Health Organization. (2018). Noncommunicable diseases country profiles 2018. Genebra. https://www.who.int/publications/i/item/ncd-country-profiles-2018
World Health Organization. (2023). Global action plan for the prevention and control of noncommunicable diseases: 2023-2030. https://www.who.int/teams/noncommunicable-diseases/governance/roadmap
World Health Organization. (2024). WHO global report on trends in prevalence of tobacco use 2000–2030. Genebra. https://www.who.int/publications/i/item/9789240088283
World Health Organization. (2025). WHO report on the global tobacco epidemic, 2025: protect people from tobacco smoke. Genebra. https://www.who.int/teams/health-promotion/tobacco-control/global-tobacco-report-2025
World Health Organization. (2025). Tobacco. Genebra. https://www.who.int/en/news-room/fact-sheets/detail/tobacco

