"Remember why you wanted to quit.” Imagine your smartwatch vibrating and flashing such a message every time you lift your hand to smoke a cigarette. Will this be enough to jolt smokers trying to quit from relapsing? In case you are among the millions struggling to quit smoking, here is some good news. Researchers from the University of Bristol have come up with the first “just-in-time” intervention app to prevent relapse. Smoking is one of the biggest hurdles to leading a healthy life. Quitting is challenging as nicotine addiction can lead to lasting dependence, often leading to withdrawal symptoms. Although most smokers manage to quit temporarily, abstaining seems like a bigger struggle, with up to 75 per cent relapsing within the first year. The research – Presenting and Evaluating a Smartwatch-Based Intervention for Smoking Relapse (StopWatch): Feasibility and Acceptability Study – published in JMIR Formative Research, shows how smartwatches can provide just-in-time support for smokers at risk of relapse. The team has developed motion sensor software that can detect hand movements that occur when a person is holding a cigarette. Each time a cigarette is detected, the app pushes an alert on the smartwatch screen, and it also sends text messages along with vibration. These messages are designed by smokers and former smokers extending support to those trying to quit. The team conducted the study on 18 participants who were daily smokers, actively seeking to quit, and those who smoked using their right hand. The participants wore the smartwatch every day for two weeks. The researchers developed the StopWatch intervention using an approach that focuses on user-centric design principles. They developed an algorithm that has the ability to detect smoking gestures through the motion sensors in a smartwatch. Later, the smartwatch offers supportive, real-time messages to encourage users to stay committed to quitting their smoking habit. The participants received real-time intervention texts whenever they attempted smoking. The study concluded with qualitative feedback from participants who were required to fill out a questionnaire. How does StopWatch work, and why smartwatches? The algorithm in the StopWatch system uses the smartwatch’s accelerometer and gyroscope to process data. These sensors are capable of detecting hand movements related to smoking gestures. In case smoking is identified, the watch sends supportive messages to the user. These messages include words of encouragement, reminders of health benefits, and alerts about smoking habits. "You've already avoided X cigarettes today! Keep going!" or "Remember why you wanted to quit," are some of the messages that flash on the smartwatch screen. Based on the research, smartwatches are worn on the wrist, which makes them the ideal device to offer real-time intervention. Smartphones, on the other hand, are not always immediately available. As part of the study, the participants were asked to wear the watch daily, charge it overnight, and give feedback about their experience. After the two weeks, many participants reported that the intervention increased their awareness about smoking triggers. They said that the real-time messages acted as reminders and encouraged them to stay committed to their goal. However, some of the participants also cited battery life and bulkiness of the smartwatch as challenges related to the device experience. Perhaps the biggest advantage of the StopWatch system is its ability to intervene at the exact moment a user is about to relapse. Based on the study, the just-in-time approach disrupts some automatic smoking behaviours and provides immediate support. Although the intervention was promising, there were limitations such as battery life, comfort, and some participants even reported false detections where non-smoking gestures triggered push alerts. While the study shows that smartwatch-based interventions are acceptable and feasible, the researchers acknowledge that improvements are needed. This study sheds light on how wearable technology can be put to a meaningful role in healthcare. As more such technologies evolve, it could potentially redefine how we approach everyday health concerns. The study was conducted by researchers from the University of Bristol, including experts from the School of Psychological Science, the Integrative Cancer Epidemiology Programme, and the MRC Integrative Epidemiology Unit. The lead author was Chris Stone, supported by researchers Rosie Essery, Joe Matthews, Felix Naughton, Marcus Munafo, Angela Attwood, and Andy Skinner.
