{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:51:25Z","timestamp":1774943485385,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.142038.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns5:p>Background Given the high prevalence of tobacco use, India presents a significant challenge in tobacco control. Yet, the support received for tobacco cessation is suboptimal. Hence, the aim of this narrative review was to identify and heuristically evaluate \u2018high-quality\u2019 and \u2018engaging\u2019 tobacco cessation mobile apps using the Mobile Application Rating Scale (MARS). Also, to categorize and analyse their features with respect to engagement, functionality, aesthetics, and information quality. Methods A systematic search of tobacco cessation apps was done within app stores of prominent smartphone platforms developed by Apple and Android. The following search terms: \u2018quit smoking,\u2019 \u2018smoking cessation, \u2018stop smoking,\u2019 \u2018smoking therapy,\u2019 \u2018quit tobacco,\u2019 \u2018cigarette cessation,\u2019 \u2018cold turkey,\u2019 and \u2018quit cigarette.\u2019 Pearson\u2019s correlations were used to analyse correlations between app scores (Total score app-quality\/mean score) and downloads\/ratings and number of downloads with the overall MARS score. A Chi-square test was performed to analyse any association between app focus and app release dates. Results Total MARS scores ranged from 3.1 to 4.9. Quitsure app (4.9), Craving to Quit! app (4.8) and Stop Tobacco Mobile Trainer: Quit Smoking App (4.74) were ranked the highest according to the MARS overall mean score. Older apps focussed more on mere goal setting or substance use, as compared to behaviour change; whereas, recently developed apps are now focussing more on behaviour change. Conclusions The content and functionality of behaviour change-focused apps were of higher quality than those of other app categories. These recently developed mHealth apps can effectively supersede the traditional smoking cessation methods.<\/ns5:p>","DOI":"10.12688\/f1000research.142038.2","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T11:40:20Z","timestamp":1732275620000},"page":"1413","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mobile applications (apps) for tobacco cessation: Behaviour change potential and heuristic analysis using the Mobile Application Rating Scale (MARS)"],"prefix":"10.12688","volume":"12","author":[{"given":"Bhargav","family":"Bhat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prajna Pramod","family":"Nayak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0181-7069","authenticated-orcid":false,"given":"Ramprasad","family":"Vasthare","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak Kumar","family":"Singhal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"27-36","DOI":"10.1007\/s10389-019-01091-3","article-title":"Recent trends of tobacco use in India.","volume":"29","author":"A Chhabra","year":"2021 Feb","journal-title":"J. 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\n<i>Posted: 15 Nov 2024<\/i>; General Comments:&nbsp;The aim of the study was to identify tobacco cessation apps on Apple and Android app stores and to categorize and analyze their features as regards to engagement, functionality, aesthetics, and information quality. Thereby recommending directions for the improvement of these apps.  Specific Comments: Title: Please specify the type of review in the title to facilitate better understanding of the article. Author Response :&nbsp;We thank the reviewer for their suggestion, the \u2018abstract\u2019 has been edited to make it clear. We could not add the type of review in the title, as it can lengthen the title further (19 words).  Abstract: MARS (Mobile Application Rating Scale) could have been incorporated into the keywords to enhance the specificity. Author Response :&nbsp;We have now added it ma\u2019am.  Introduction  Kindly give reference for the following lines in the introduction section: \u201cThe majority of people making independent attempts fail to maintain their quit status for even one month.\u201d The second para of this section provides statistics on tobacco cessation from India. However, the following paragraph discusses global statistics on smartphone users, which appears to be out of sync with the flow of information. To maintain coherence, it would be better to align the information properly. The rationale of the review was well articulated in the introduction although a little more background on MARS and its scoring system and how it helps in heuristically evaluating the mhealth applications could be provided to strengthen the foundation of the study.  Author Response :  We have now added the reference, ma\u2019am. .We have now provided India statistics to synchronize with the tobacco cessation statistics. We have now provided details on the MARS scale. More details are available in the methodology section ma\u2019am.  Methodology:  The introduction highlights that rankings in app stores are highly volatile and primarily influenced by app usability, meaning that an app's behavior change potential cannot be fully assessed based on its ratings or popularity alone. However, the inclusion criteria in the methods section focus on selecting apps with a rating of 4 stars or higher and more than 10,000 downloads. Justify. The inclusion of only apps with a rating of 4 stars or higher and over 10,000 downloads might exclude newer or less popular apps that could still be effective. This introduces a bias towards more established apps. Kindly justify. The reviewers were trained using a 37-minute YouTube video. Please answer the following questions: a)&nbsp;It may not be sufficient for thorough, expert-level assessment using the MARS tool. Kindly comment. b)&nbsp;While a high interrater reliability (0.804) is reported, no additional details are provided on how discrepancies between reviewers were resolved. This could affect the validity of the scoring and analysis if disagreements were not consistently addressed. Justify. c) How reliable and authentic was the video? It is suggested to include the link for the video in the references.&nbsp; There\u2019s no mention of how frequently the apps were updated or if the study accounted for updates during the research period in the methods section. App features and functionalities can change significantly with updates, which could affect the evaluation. It is suggested to include details regarding the same. Less information is provided on the availability of the mhealth application, especially if is it limited to India (developed) or Indian context. This may be an important factor as some of the apps belonging to the western population could not be practical for lifestyle or behavior change therapies among Asian Indians. Statistical analyses used in the review seem basic thus undermining the actual benefits of the application and how it could be practically applied. Although the review outlines the combined effects of all the 20 applications, additional specifications or features of at least the top 5 applications could be briefed out to demonstrate how pragmatic these apps are for everyday practice.  Author Response :&nbsp;  We have now added the justification in the 1\n<sup>st<\/sup> para of Discussion, ma\u2019am. We have now added the justification in the 1\n<sup>st<\/sup> para of Discussion and also mentioned in the limitations, ma\u2019am. Since the video was uploaded by the developer of the scale himself, we used it as a reference for understanding the scale better. We have also added on how the discrepancies were resolved in the Methods section. (13) MARS training video - YouTube , we have now added the link to the video, ma\u2019am. As the study was conducted in a relatively short period of time, we have not mentioned updates during study period. Since the Apple and Android App stores both show all the apps, irrespective of the country that developed the app, we could not isolate the Indian apps. Also, we did not have access to numerous international apps created exclusively for use within each nation as phone numbers were required for registration and app usage. As this could lengthen the manuscript, we could not brief on top 5 apps. Instead, we have tried to summarize the results of top 20 apps distinctly.  Results:  It is recommended to provide a separate breakdown in Figure 2 for each reviewer, rather than presenting an overall summary. For example, indicate how many apps were identified by Reviewer 1 and how many were identified by Reviewer 2 using the search terms. While the study title emphasizes behavior change, &quot;Mobile applications (apps) for tobacco cessation: Behavior change potential and heuristic analysis using the Mobile Application Rating Scale (MARS),&quot; the majority of the apps reviewed (14) primarily focused on goal-setting, with only 4 targeting behavior change directly. Justify. The final number of apps subjected to analysis (20 out of 670) is very small (only 3 apps from iOS). The sample size may be too small to yield reliable or meaningful statistical significance. This limits the generalizability of the findings &quot;Chi-square test was performed to analyze any association between app focus and app release dates. Older apps focused more on mere goal setting or substance use, as compared to behavior change. Apps that have been recently developed are now focusing more on behavior change and these results were statistically significant (P value = 0.000).&quot; What is the definition of older apps? According to table 1, 50% apps were release between years 2019-2023 and an equal number were updated in 2023. This contradicts the results where the authors have mentioned that there were only 4 apps targeting behavior change. Table showing correlation and chi square test is missing. It is suggested to remove pie chart as this is not adding any value to the manuscript. Further explanation of statistical tests, confidence intervals, and potential confounding factors would enhance the clarity and rigor of the analysis. Additionally, providing more detail on the interpretation of correlations and the significance of app focus trends would strengthen the discussion of results.  Author Response :&nbsp;  Though both authors downloaded, selected and excluded apps together and then reviewed each app independently. Since we had to unbiasedly select the apps out of 54 apps, we included only the highly rated and most downloaded apps. Focus of the apps were checked later during the study.  Nevertheless, other 14 apps, though had primary focus as goal setting, also had behavior counselling in their content. Hence, we have included them.  Though we initially got 670 apps, the actual tobacco cessation apps were only 54. (Figure 2 flowchart for app identification). Hence, 20 out of 54 were selected, ma\u2019am. We have now added a table mentioning the app release dates and app primary focus. (Table 6). We have now added it ma\u2019am (Table 5) We have removed the pie chart now. We have now mentioned.  Discussion:  This is the line from discussion section: \u201cAccording to the findings of our study, the apps that focus on behavior modification had higher user ratings and overall MARS scores with many features.\u201d a)&nbsp;Since, authors are talking a lot about these apps. In the results section as well It is suggested to include the app names based on this categorization in the results section for clearer reference. b)&nbsp;Also, while the study notes that most apps focused on goal setting. There is little exploration of the implications of having a majority of apps focused on goal setting rather than behavior change. Some points mentioned in other sections of the study are repeated, such as the focus on the MARS scale and its dimensions. Kindly avoid such repetitions. &quot;Our study found more than 622 smoking cessation apps in both platforms. It is concerning that the app stores for smoking cessation applications is saturated with apps of low quality, perhaps making it difficult for users who aren't the most selective to find higher-quality apps.&quot;  For the above statement, What criteria were used to determine low quality of an app? &nbsp; The discussion mentions similarities with previous studies but does not provide a detailed comparison or analysis of how the current findings add to or differ from existing literature. The recommendation for developing more behavior change-focused apps lacks specificity and concrete suggestions on features. Kindly review the calculation for the apps excluded. The number mentioned in results (558) and the number mentioned in fig 2 (54) gives a difference of 10 which is missed out in the review. Recheck and update the table or the count. While the discussion does a great job of highlighting the importance of behavior change apps, it could benefit from a deeper exploration of why behavior change techniques (e.g., cognitive-behavioral therapy, acceptance and commitment therapy) are more effective in driving smoking cessation. A more detailed explanation of the mechanisms behind these techniques, backed by literature, would strengthen the argument and provide additional value to readers who may be unfamiliar with these approaches.  Author Response :&nbsp;  We have now named those apps focusing on behavior change in the results section. Although the primary focus of majority of apps was goal setting, they also had behavior modification components in them. We have now removed the repetitions, ma\u2019am. Most of the other apps had mere goal setting or basic details of health affects before and after quitting tobacco. Hence we had mentioned like so. We thank the reviewers for drawing attention on this, and we have now corrected the sentence. We have now added. We have now added ma\u2019am. We have corrected it. We have now briefly explained important behavior change techniques for smoking cessation.","URL":"https:\/\/f1000research.com\/articles\/12-1413\/v2#referee-comment-12833","order":2,"name":"referee-comment-12833","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.174893.r380805, Jinsong Chen, The University of Auckland, Auckland, Auckland, 26 May 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-1413\/v2#referee-response-380805","order":3,"name":"referee-response-380805","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}