Evaluating the feasibility and acceptability of a smartwatch-based smoking relapse intervention ('StopWatch')

Introduction: Despite the benefits of smoking cessation, maintaining abstinence during a quit attempt is difficult and most attempts result in relapse. Innovative, evidence-based methods of preventing relapse are needed. We present a smartwatch-based relapse prevention system that uses passive detection of smoking (using the StopWatch platform) to trigger just-in-time smoking cessation support.
Methods: The Person-Based Approach for intervention development (Yardley, 2015) was used to design the StopWatch smoking relapse intervention with messaging co-designed by smokers. Intervention delivery was triggered by an algorithm identifying smoking behaviour from the smartwatch’s motion sensors, and the intervention messages were delivered on the smartwatch screen. Twenty smokers tested the intervention over a two-week period and provided qualitative feedback on acceptability of both the intervention and the smartwatch platform. Data on intervention adherence was also recorded by the smartwatch.
Results: Participants reported that the smartwatch intervention led to increased awareness of smoking, and motivated them towards quitting. Intervention messages were generally felt to be relevant and timely. There were some challenges with battery life that had implications for intervention adherence, and the bulkiness of the device and the notification style reduced some participants’ acceptability of the smartwatch platform.
Conclusions: The combination of sensors for passive detection, provision for messaging, and on-board processing in a convenient, always-to-hand wearable format makes a smartwatch a potentially powerful tool to host a just-in-time behaviour change intervention. Our findings indicate our smoking relapse intervention is both feasible and acceptable to participants as a relapse prevention intervention, and also highlighted some challenges to be overcome in future implementation.