What Will Entail Adoption of a Mobile Coaching Service?: The Case of Smoking Cessation Services

Introduction

Addictions to tobacco, alcohol, drugs, over-eating, caffeine and pathological gambling are a serious problem for society. Breaking the habit takes enormous willpower, and in many cases the help of therapists or support groups. The rising popularity of smartphones, has led to a dramatic increase in mobile services through apps. The current tendency to use cell phones or other mobile devices for health offers a very interesting opportunity to improve public health worldwide (Stanford Social Innovation Review, 2011).

A study reported that a great number of smokers in Anglo-Saxon countries had downloaded and used health apps (Borelli et al, 2015). But research also suggests that a big proportion of users stop using health apps soon after they have been downloaded (Krebs & Duncan, 2015). App developers should include more engagement features (Ubhi et al., 2016) such as the use of gamification (Lister, et al. 2014) defined as the use of game design elements in non-game contexts (Detering et al., 2011).

One such service could provide support for giving up smoking. According to the report of PwC (2013), by 2017, mHealth has the potential to save 2.6 billion EUR by helping people quit smoking. This type of service is relatively new in France, hence the relevance of studying the profile of potential adopters.

In France, almost 78,000 deaths each year are directly attributable to smoking (about 6 million in the World, one death every 6 seconds). Tobacco consumption is the most significant cause of premature death in the EU. Around 50% of smokers die on average 14 years earlier (European Union, Public health 2017). From the overall European population, 28% are smokers and 29% of young Europeans aged 15-24 smoke. Across the whole French population 16 million smoke. A third aged 15-85 smoke at least once in a while (36% men, 28% women). The proportion of daily smokers rose from 26.9% to 28.7% between 2005 and 2010 and has been stable since.

Also, cigarette sales saw a slight upturn between 2008 and 2009 (from 53.6 billion to 55 billion packets) after dropping significantly between 2001 and 2004 (from 82.5 billion to 54.9 billion, due to substantial increases in the price of tobacco products). At 7 euros the pack, French smokers already pay one of the highest price in the European Union, surpassed only by Britain and Ireland. Around 80% of the cost of a pack goes to the government in tax, bringing in €14 billion in revenue each year. In 2016, the government introduced neutral cigarette packets covered with graphic health warnings. By 2017, the government is considering increasing the price to 10 euros the pack (The French government launched in November 2017 the “One month without tobacco event”, Appendix 2).

However, the proportion of smokers that smoke more than ten cigarettes a day is diminishing. The French smokers are usually very young and represent 50% of the smoker people (about 94% of the smokers in EU start smoking before they turn 25). Considering 16 million of French smokers (more than 100 million in the world), more than half would like to stop smoking. Only 750 000 (nearly 5% of the smoker people) people stop smoking each year. More than 2 million of smokers used skin patches, nicotine substitute or pharmacological processing in 2010. But a research suggests that smokers who buy nicotine replacement medicine over-the-counter without any professional help have similar odds of stopping smoking as those who try to stop smoking without any aid (Kotz et al., 2014).