{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:50:48Z","timestamp":1782845448935,"version":"3.54.5"},"reference-count":32,"publisher":"JMIR Publications Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tobacco use continues to be the leading preventable cause of death, disease, and disability in the United States. Since 2000, Washington state has offered free tobacco \u201cquitline\u201d services to help its residents stop using tobacco. In 2015, the state began offering free access to a tobacco cessation smartphone app to absorb excess quitline demand. Since most publicly funded tobacco cessation programs are designed to provide access to populations disproportionately impacted by tobacco use, it is important to consider who these public health interventions reach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study is to understand who used a free cessation app and the extent to which users represented populations disproportionately impacted by tobacco use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is an observational study of 1280 adult Washington state residents who registered for and activated the cessation app. Demographic data were collected as part of the sign-up process, examined using standard descriptive measures, and assessed against state-level surveillance data for representativeness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were primarily non-Hispanic White (978\/1218, 80.3%), identified as female (780\/1236, 63.1%), were between ages 25-54 years (903\/1186, 76.1%), had at least some college education (836\/1222, 68.4%), and reported a household income under US $50,000 (742\/1055, 70.3%). Fewer respondents were from rural counties (359\/1220, 29.4%); identified as lesbian, gay, bisexual, pansexual, queer, questioning, or asexual (LGBQA; 153\/1222, 12.5%); were uninsured (147\/1206, 12.2%); or were currently pregnant, planning pregnancy, or breastfeeding (42\/624, 6.7%). However, relative to available state data for tobacco users, there was high representation of women, 35- to 54-year-olds, college graduates, and LGBQA individuals, as well as individuals with low household income, poor mental health, Medicaid insurance, and those residing in rural counties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A diverse population of tobacco users will use a free cessation app, including some demographic groups disproportionately impacted by tobacco use. With high reach and high efficacy, it is possible to address health disparities associated with tobacco use and dependence treatment among certain underserved and at-risk groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/32499","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T10:50:42Z","timestamp":1640602242000},"page":"e32499","source":"Crossref","is-referenced-by-count":15,"title":["Analysis of Demographic Characteristics of Users of a Free Tobacco Cessation Smartphone App: Observational Study"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6625-3866","authenticated-orcid":false,"given":"Nick","family":"Fradkin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9602-0545","authenticated-orcid":false,"given":"Susan M","family":"Zbikowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9757-0848","authenticated-orcid":false,"given":"Trevor","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"ref1","unstructured":"U.S. Department of Health and Human ServicesThe health consequences of smoking\u201450 years of progress: a report of the Surgeon GeneralNational Center for Biotechnology Information20142021-12-15https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK179276\/"},{"key":"ref2","unstructured":"United States Public Health Service Office of the Surgeon GeneralNational Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health.Smoking cessation: a report of the Surgeon GeneralNational Center for Biotechnology Information20202021-12-15https:\/\/pubmed.ncbi.nlm.nih.gov\/32255575\/"},{"key":"ref3","unstructured":"U.S.DOHSHow tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon GeneralNational Center for Biotechnology Information20102021-12-15https:\/\/pubmed.ncbi.nlm.nih.gov\/21452462\/"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1211128"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6946a4"},{"key":"ref6","unstructured":"Behavioral Risk Factor Surveillance System (BRFSS)Washington State Department of Health2022-02-02https:\/\/www.doh.wa.gov\/DataandStatisticalReports\/DataSystems\/BehavioralRiskFactorSurveillanceSystemBRFSS"},{"key":"ref7","unstructured":"QuickFacts - 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