{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:03:39Z","timestamp":1782846219248,"version":"3.54.5"},"reference-count":36,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Despite the popularity of concurrent use of electronic cigarettes (e-cigarettes) and cigarettes (dual tobacco use) among young adults, few interventions address the cessation of both tobacco products. The application of a human-centered design (HCD) approach in the development of such interventions remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study used an HCD approach to develop smartphone-based intervention messages for dual tobacco cessation for young adults.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Intervention messages were developed based on theories, cessation guidelines, existing messages, and our previous formative study. Three rounds of message testing were conducted asynchronously via an online platform with 35 young adults (18\u201029 years old) who currently used both e-cigarettes and cigarettes and were motivated to quit either smoking or vaping in the next 6 months. In each round, a new sample of 10\u201012 participants evaluated the messages individually. For the quantitative assessment, participants viewed and rated each message on a scale from 1 (\u201cvery low degree\u201d) to 5 (\u201cvery high degree\u201d) across 4 components: Comprehension (\u201cThis message is easy to understand\u201d), Usefulness (\u201cThis message is useful for encouraging tobacco cessation\u201d), Tone (\u201cThe language is clear and non-judgmental\u201d), and Design (\u201cThe design is appealing\u201d). For the qualitative assessment, participants used a platform-enabled feature to place markers on specific parts of messages they liked, disliked, or found confusing and then provided brief explanations for their feedback. Initial messages were assessed during the first 2 rounds of testing, and those with low mean scores were revised based on participants\u2019 feedback and retested in the third round.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We found significant improvements in message ratings after refinement. The overall mean score increased from 3.6 (SD 0.4) to 4.6 (SD 0.2) (\n P<\/jats:italic>\n <.001), using paired\n t<\/jats:italic>\n tests. Specifically, the mean score of \u201cComprehension\u201d improved from 4.0 (SD 0.5) to 4.9 (SD 0.2) (\n P<\/jats:italic>\n <.001), the mean score of \u201cUsefulness\u201d increased from 3.0 (SD 0.6) to 4.4 (SD 0.4) (\n P<\/jats:italic>\n <.001), the mean score of \u201cTone\u201d increased from 3.8 (SD 0.6) to 4.8 (SD 0.2) (\n P<\/jats:italic>\n <.001), and the mean score of \u201cDesign\u201d increased from 3.4 (SD 0.48) to 4.4 (SD 0.3)\n (P<\/jats:italic>\n <.001). The qualitative assessments highlighted design elements related to message liking, such as clear layout, minimalistic imagery, italicized quotes, and highlighted keywords. Conversely, design features related to message dislike included color shades, lengthy text, and confusing wording.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study demonstrated the use of HCD in developing smartphone-based intervention messages to support dual tobacco cessation among young adults. Integrating remote message testing improved the feasibility of rapid prototyping while enhancing the relevance and appeal of message content and design. Future interventions targeting emerging health behaviors among young adults may benefit from incorporating a remote testing method to efficiently gather user feedback and refine intervention messages in a timely manner.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/76503","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:11:13Z","timestamp":1758201073000},"page":"e76503-e76503","source":"Crossref","is-referenced-by-count":0,"title":["Applying Human-Centered Design to Develop Smartphone-Based Intervention Messages to Help Young Adults Quit Using E-Cigarettes and Cigarettes: A Remote User Testing Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4708-6027","authenticated-orcid":false,"given":"Thi Phuong Thao","family":"Tran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3240-6105","authenticated-orcid":false,"given":"Christine","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-9347","authenticated-orcid":false,"given":"Pamela M","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-4579","authenticated-orcid":false,"given":"Lucy","family":"Popova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-9597","authenticated-orcid":false,"given":"Nhung","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"issue":"11","key":"R1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.40859","article-title":"E-cigarette use among US adults in the 2021 behavioral risk factor surveillance system survey","volume":"6","author":"Erhabor","journal-title":"JAMA Netw Open"},{"issue":"10","key":"R2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.20694","article-title":"Demographic characteristics, cigarette smoking, and e-cigarette use among US adults","volume":"3","author":"Mayer","journal-title":"JAMA Netw Open"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300229","article-title":"Population-based disease odds for E-cigarettes and dual use versus cigarettes","volume":"3","author":"Glantz","journal-title":"NEJM Evid"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2024.107970","article-title":"Dual and poly-nicotine and tobacco use among adolescents in the United States from 2011 to 2022","volume":"152","author":"Zhang","journal-title":"Addict Behav"},{"issue":"5","key":"R5","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1136\/tc-2022-057804","article-title":"\u201cI\u2019m both smoking and vaping\u201d: a longitudinal qualitative study of US young adults who tried to quit smoking cigarettes by using electronic cigarettes","volume":"33","author":"Nguyen","journal-title":"Tob Control"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2196\/63156","article-title":"Desires and needs for quitting both e-cigarettes and cigarettes among young adults: formative qualitative study informing the development of a smartphone intervention for dual tobacco cessation","volume":"8","author":"Nguyen","journal-title":"JMIR Form Res"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jadohealth.2021.07.011","article-title":"Tobacco cessation behaviors among U.S. middle and high school students, 2020","volume":"70","author":"Zhang","journal-title":"J Adolesc Health"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"E336","DOI":"10.9778\/cmajo.20210325","article-title":"Scoping review of guidance on cessation interventions for electronic cigarettes and dual electronic and combustible cigarettes use","volume":"11","author":"Kundu","journal-title":"CMAJ Open"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s40429-019-00248-0","article-title":"Mobile applications for the treatment of tobacco use and dependence","volume":"6","author":"Vilardaga","journal-title":"Curr Addict Rep"},{"key":"R10","unstructured":"Demographics of mobile device ownership and adoption in the United States. 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