Feasibility and Acceptability of Using Wi-Fi Access Points to Provide Smoking Cessation Help at 17 Airports and 38 Railway Stations Across China
Tobacco use remains a significant threat to global health, contributing to approximately 7 million deaths annually. In China, the situation is particularly dire, with 44% of the world’s cigarettes consumed there and 1 million tobacco-related deaths each year. Smoking cessation is a critical intervention to reduce these harms, and various methods, including pharmacotherapy, physician counseling, hotline interventions, and acupuncture, have been employed to support quitting efforts. With the high penetration of mobile technology in China, mobile health (mHealth) presents a promising avenue for delivering smoking cessation support. Among mHealth strategies, mobile phone-based interventions have been shown to significantly improve cessation outcomes. However, the feasibility and acceptability of such interventions in the Chinese population remain unclear. This study explores the use of Wi-Fi access points (APs) as a platform to provide smoking cessation help at 17 airports and 38 railway stations across China, aiming to assess its effectiveness and acceptance among travelers.
The study was conducted in two stages: platform development and population survey. In the first stage, a survey platform was developed and integrated into the Wi-Fi services at 17 airports and 38 railway stations. When users attempted to access the Wi-Fi, a pop-up window presented the survey content, inviting them to participate. The platform was developed by OPSMART Technology Company, utilizing PL/SQL on an Oracle 8 database server and HTML5 for mobile phone displays. The file size was minimized to 15 kb to reduce download time, and the total programming, testing, and verification took approximately 40 hours. The survey was divided into three pages: an introduction page highlighting the dangers of smoking and the benefits of cessation, a main survey page with demographic and smoking-related questions, and a reward page where participants could enter their mobile phone number to receive a data roaming package worth $20.
In the second stage, a population survey was conducted to assess the intention to receive tobacco cessation support. The survey was launched during the 2016 World No-Tobacco Day and was available at the 55 study sites across China. Participants were sampled conveniently, with inclusion criteria requiring voluntary participation, ability to read Chinese, and being aged 18 or older. The survey was anonymous and confidential, and participants were compensated with the data roaming package upon completion. The six-question questionnaire collected information on age, gender, smoking status, and intention to receive cessation support. The survey took approximately 3 to 5 minutes to complete.
A total of 20,199 users participated in the survey, with 13,628 submitting responses, yielding a response rate of 67.47%. The smoking rate among participants was 30.9%, with 86.58% of smokers and 2.44% of non-smokers expressing a desire to receive cessation support. Multivariate analysis revealed that the intention to receive support did not significantly differ by age, gender, or heaviness of smoking. Among smokers, 41.02% submitted the survey at airports, while 58.98% did so at railway stations. The majority of participants were male, with an average age of 33.83 years. The study found that 86.58% of smoking participants and 2.44% of non-smoking participants wished to receive cessation support. Further analysis showed no significant differences in gender, age, cigarettes smoked per day, or duration of smoking between those who intended to receive support and those who did not.
The findings of this study demonstrate that providing tobacco cessation support via Wi-Fi APs is both feasible and efficient. The high intention to receive support among smokers suggests that this method could be a valuable tool in reducing smoking prevalence in China. The study’s strengths include its novel approach, high recruitment numbers, and the wide variety of study sites. Additionally, the cost of the survey was relatively low compared to other mHealth methods, such as short-message services and smartphone applications. This study also highlights the importance of collaboration among medical professionals, government agencies, telecom operators, and IT professionals in implementing such interventions.
However, the study has several limitations. The response rate, while moderate, could be improved in future research. The compensation of a data roaming package may have influenced participation rates, potentially overestimating the effectiveness of the survey. Additionally, the survey was conducted at airports and high-speed railway stations, which may introduce selection bias. The study also primarily recruited young and middle-aged participants, potentially omitting older individuals who may have different smoking behaviors and cessation needs.
Despite these limitations, the study provides valuable insights into the use of Wi-Fi APs for smoking cessation support. Future research should focus on refining the methodology and verifying the efficacy of this approach through clinical trials. The integration of traditional treatment methods into mHealth, along with surveillance and quality control measures, will be essential for the successful implementation of such interventions. Addressing potential medical disputes and ensuring long-term return on investment will also be critical.
In conclusion, this study demonstrates that providing tobacco cessation support via Wi-Fi APs is feasible, efficient, and acceptable among smokers in China. The high intention to receive support indicates that this method could play a significant role in reducing smoking prevalence. Future studies should build on these findings to develop targeted and individualized recruitment strategies based on predictors of cessation intention. Collaboration among hospitals, academia, IT industries, and government agencies will be essential to advancing mHealth for tobacco cessation in China and beyond.
doi.org/10.1097/CM9.0000000000000230
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