Online Exclusive Article

Mobile Health-Based Approaches for Smoking Cessation Resources

Sookyung Hyun

Julie Keany Hodorowski

Anita Nirenberg

Rosemarie Slevin Perocchia

Jo Anne Staats

Olivia Velez

Suzanne Bakken

mobile applications, mobile apps, smoking, smoking cessation
ONF 2013, 40(4), E312-E319. DOI: 10.1188/13.ONF.E312-E319

Purpose/Objectives: To describe how the National Cancer Institute's Cancer Information Service (CIS) smoking-related resources on a mobile health (mHealth) platform were integrated into the workflow of RNs in advanced practice nurse (APN) training and to examine awareness and use of CIS resources and nurses' perceptions of the usefulness of those CIS resources.

Design: Descriptive analyses.

Setting: Acute and primary care sites affiliated with the School of Nursing at Columbia University.

Sample: 156 RNs enrolled in APN training.

Methods: The integration was comprised of (a) inclusion of CIS information into mHealth decision support system (DSS) plan of care, (b) addition of infobutton in the mHealth DSS, (c) Web-based information portal for smoking cessation accessible via desktop and the mHealth DSS, and (d) information prescriptions for patient referral.

Main Research Variables: Use and perceived usefulness of the CIS resources.

Findings: 86% of nurses used the mHealth DSS with integrated CIS resources. Of the 145 care plan items chosen, 122 were referrals to CIS resources; infobutton was used 1,571 times. Use of CIS resources by smokers and healthcare providers in the metropolitan area of New York City increased during the study period compared to the prestudy period. More than 60% of nurses perceived CIS resources as useful or somewhat useful.

Conclusions: Integration of CIS resources into an mHealth DSS was seen as useful by most participants.

Implications for Nursing: Implementation of evidence into workflow using an mHealth DSS can assist nurses in managing smoking cessation in patients and may expand their roles in referring smokers to reliable sources of information.

Knowledge Translation: mHealth DSS and information prescriptions may support smoking cessation interventions in primary care settings. Smoking cessation interventions can be facilitated through informatics methods and mHealth platforms. Nurses' referrals of patients to smoking-related CIS resources may result in patients' use of the resources and subsequent smoking cessation.

Jump to a section


    Akter, S., & Ray, P. (2010). mHealth-an ultimate platform to serve the unserved. Yearbook of Medical Informatics, 94-100.
    American Lung Association. (2011). Trends in tobacco use. Retrieved from
    Bakken, S., Cook, S. S., Curtis, L., Desjardins, K., Hyun, S., Jenkins, M., … Soupios, M. (2004). Promoting patient safety through informatics-based nursing education. International Journal of Medical Informatics, 73, 581-589. doi:10.1016/j.ijmedinf.2004.04.008
    Bakken, S., Roberts, W., Chen, E., Dilone, J., Lee, N. J., Mendonca, E., & Markatou, M. (2007). PDA-based informatics strategies for tobacco use screening and smoking cessation management: A case study. Studies in Health Technology and Informatics, 129, 1447-1451.
    Berry, D. L., Halpenny, B., Hong, F., Wolpin, S., Lober, W. B., Russell, K. J., … Swanson, G. (2011). The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: A multi-center randomized trial. Retrieved from
    Blake, H. (2008). Innovation in practice: Mobile phone technology in patient care. British Journal of Community Nursing, 13, 160, 162-165.
    Borrelli, B., Hecht, J., Papandonatos, G., Emmons, K., Tatewosian, L., & Abrams, D. (2001). Smoking-cessation counseling in the home. Attitudes, beliefs, and behaviors of home healthcare nurses. American Journal of Preventative Medicine, 21, 272-277.
    Bright, M. A. (2007). The National Cancer Institute's Cancer Information Service: A premiere cancer information and education resource for the nation. Journal of Cancer Education, 22(1, Suppl.), S2-S7.
    Burack, R. C., Gimotty, P. A., George, J., Simon, M. S., Dews, P., & Moncrease, A. (1996). The effect of patient and physician reminders on use of screening mammography in a health maintenance organization. Results of a randomized controlled trial. Cancer, 78, 1708-1721.
    Centers for Disease Control and Prevention. (2007). Decline in smoking prevalence—New York City, 2002-2006. MMWR, 56, 604-608.
    Centers for Disease Control and Prevention. (2011). Current cigarette smoking among adults and trends in smoking cessation—United States, 2011. MMWR, 61, 889-894.
    Chan, S. S., Sarna, L., Wong, D. C., & Lam, T. H. (2007). Nurses' tobacco-related knowledge, attitudes, and practice in four major cities in China. Journal of Nursing Scholarship, 39, 46-53. doi:10.1111/j.1547-5069.2007.00142.x
    Cimino, J. J. (2006). Use, usability, usefulness, and impact of an Infobutton Manager. American Medical Informatics Association Symposium, 151-155.
    Clifford, G. D., & Clifton, D. (2012). Wireless technology in disease management and medicine. Annual Review of Medicine, 63, 479-492. doi:10.1146/annurev-med-051210-114650
    Cokkinides, V. E., Ward, E., Jemal, A., & Thun, M. J. (2005). Under use of smoking-cessation treatments: Results from the National Health Interview Survey, 2000. American Journal of Preventative Medicine, 28, 119-122.
    Doolan, D. M., & Froelicher, E. S. (2006). Efficacy of smoking cessation intervention among special populations: Review of the literature from 2000-2005. Nursing Research, 55(4, Suppl.), S29-S37.
    Fiore, M., Jaén, C., Baker, T., Bailey, W., Benowitz, N., Curry, S., … Froelicher, E. (2008). Clinical practice guideline. Treating tobacco use and dependence: 2008 update. Rockville, MD: U. S. Department of Health and Human Services Public Health Service.
    Hall, S., Vogt, F., & Marteau, T. M. (2005). A short report: Survey of practice nurses' attitudes toward giving smoking cessation advice. Family Practice, 22, 614-616.
    Handel, M. (2011). mHealth (Mobile Health)-Using Apps for Health and Wellness. Explore (NY), 7, 256-261.
    Joint Commission. (2011). Keeping your hospital property smoke-free. Retrieved from
    Krishna, S., Boren, S. A., & Balas, E. A. (2009). Healthcare via cell phones: A systematic review. Telemedicine Journal and E-Health, 15, 231-240.
    Lancaster, T., & Stead, L. F. (2005). Individual behavioural counselling for smoking cessation. Cochrane Database of Systematic Reviews 2005, CD001292.
    La Porta, M., Hagood, H., Kornfeld, J., & Treiman, K. (2007). Evaluating the NCI's Cancer Information Service Contact Centers: Meeting and exceeding the expectations of the public. Journal of Cancer Education, 22(1, Suppl.), S18-S25.
    Lobach, D. F., & Hammond, W. E. (1994). Development and evaluation of a computer-assisted management protocol (CAMP): Improved compliance with care guidelines for diabetes mellitus. American Medical Informatics Association Symposium, 787-791.
    Lobach, D. F., Kawamoto, K., Anstrom, K. J., Russell, M. L., Woods, P., & Smith, D. (2007). Development, deployment, and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard. Studies in Health Technology and Informatics, 129, 861-865.
    Mahon, S. M. (2005). Review of selected approaches to promoting smoking cessation. Clinical Journal of Oncology Nursing, 9, 745-747. doi:10.1188/05.CJON.745-747
    Marcy, T. W., Skelly, J., Shiffman, R. N., & Flynn, B. S. (2005). Facilitating adherence to the tobacco use treatment guideline with computer-mediated decision support systems: Physician and clinic office manager perspectives. Preventive Medicine, 41, 479-487.
    McCarty, M. C., Hennrikus, D. J., Lando, H. A., & Vessey, J. T. (2001). Nurses' attitudes concerning the delivery of brief cessation advice to hospitalized smokers. Preventive Medicine, 33, 674-681.
    McPhee, S. J., Bird, J. A., Fordham, D., Rodnick, J. E., & Osborn, E. H. (1991). Promoting cancer prevention activities by primary care physicians: Results of a randomized, controlled trial. JAMA, 266, 538-544.
    National Cancer Institute. (2007). Health Information National Trends Survey. Brief 7: Health Communication: Considerations to developing effective health communication strategies. Retrieved from
    Perocchia, R. S., Hodorowski, J. K., Williams, L. A., Kornfeld, J., Davis, N. L., Monroe, M., & Bright, M. A. (2011). Patient-centered communication in cancer care: The role of the NCI's Cancer Information Service. Journal of Cancer Education, 26, 36-43. doi:10.1007/s13187-010-0121-y
    Perocchia, R. S., Rapkin, B., Hodorowski, J. K., Davis, N. L., McFarlane, A. R., & Carpenter, R. (2005). Raising awareness of online cancer information: Helping providers empower patients. Journal of Health Communication, 10(Suppl. 1) 157-172.
    Pringle, R. (2002). What rural nurses hope to find on the Internet. Online Journal of Nursing Informatics. Retrieved from
    Sarna, L., Bialous, S., Wells, M., Kotlerman, J., Wewers, M. E., & Froelicher, E. S. (2009). Frequency of nurses' smoking cessation interventions: Report from a national survey. Journal of Clinical Nursing, 18, 2066-2077. doi:10.1111/j.1365-2702.2009.02796.x
    Sarna, L., Brown, J., Lillington, L., Rose, M., Wewers, M., & Brecht, M. (2000). Tobacco interventions by oncology nurses in clinical practice: Report from a national survey. Cancer, 89, 881-889. doi:10.1002/1097-0142(20000815)89:4<881::AID-CNCR22>3.0.CO;2-M
    Sheldon, L., Hong, F., & Berry, D. (2011). Patient-provider communication data: Linking process and outcomes in oncology care. Cancer Management and Research, 3, 311-317.
    Smith, J. C., & Schatz, B. R. (2010). Feasibility of mobile phone-based management of chronic illness. American Medical Informatics Association Symposium, 757-761.
    Vas, J., Méndez, C., Perea-Milla, E., Vega, E., Panadero, M. D., León, J. M., … Jurado, R. (2004). Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: Randomised controlled trial. BMJ, 329, 1216. doi:10.1136/bmj.38238.601447.3A
    Wells, S., Furness, S., Rafter, N., Horn, E., Whittaker, R., Stewart, A., … Jackson, R. (2008). Integrated electronic decision support increases cardiovascular disease risk assessment four fold in routine primary care practice. European Journal of Cardiovascular Prevention and Rehabilitation, 15, 173-178. doi:10.1097/HJR.0b013e3282f13af4
    Wolfenden, L., Wiggers, J., Knight, J., Campbell, E., Spigelman, A., Kerridge, R., & Moore, K. (2005). Increasing smoking cessation care in a preoperative clinic: A randomized controlled trial. Preventive Medicine, 41, 284-290. doi:10.1016/j.ypmed.2004.11.011