App-based smoking cessation intervention
Smartphone app-based smoking cessation intervention for people with mental health issues who smoke: Development and pilot trial
Category: Mental Wellbeing Innovation
Target audience: People with mental health conditions who smoke
Research innovator: Dr Jinsong Chen
The project
A systematic literature review led to the development and pilot of a smartphone-based smoking cessation app specifically tailored for people with mental health conditions who smoke.
The project was carried out in two phases. Phase 1 included the systematic literature review, which revealed a lack of targeted mobile interventions for this population, and led to the co-design of an app prototype using behavioural change theory, clinical guidelines, and collaborative product development methods. The second part of the project involved a pilot randomized controlled trial (RCT) to evaluate the app’s preliminary effectiveness in improving smoking abstinence and mental health outcomes.
The goal of this project was to create an accessible, evidence-based intervention that could improve both physical and mental health outcomes for a population often underserved by traditional smoking cessation services.
Project Background
The motivation stemmed from the intersection of three public health concerns in New Zealand:
High smoking prevalence among people with mental health issues
Significant ethnic and socioeconomic disparities in smoking (particularly among Māori populations)
The strong bidirectional relationship between smoking and mental health.
While Dr Chen anticipated a growing body of evidence-based apps targeting this population, he found that very few existed. Only ten studies met the inclusion criteria of this exploration, and most were small-scale pilot trials or qualitative studies with limited statistical power.
Despite the strong link between mental health and smoking, only one study out of the ten actually measured changes in mental health status as an outcome. That study did find a significant reduction in depressive symptoms among app users, but the mechanism behind this effect remains unclear. This highlighted a significant evidence gap in a high-need population, and underscores the need to better integrate and evaluate mental health outcomes in future intervention designs.
Research and development process
The team conducted the first known dual-stream systematic review that evaluated both academic literature-based and commercial app store-based smoking cessation apps specifically for people with mental health conditions.
This comparative approach revealed a clear innovation gap between academically sound interventions and widely accessible tools—highlighting the need for translational work to bring research-driven solutions to the public domain.
The project team then introduced a collaborative product development (CPD) framework, engaging not just researchers, but also digital health designers, mental health experts, and smoking cessation practitioners. This participatory model ensures that the proposed smartphone app is not only evidence-based but also culturally appropriate, usable, and engaging.
The intervention uniquely integrates behavioral activation therapy for depression (BAT-D) and the Behaviour Change Wheel into a digital platform tailored for dual-purpose support: smoking cessation and mental health improvement. This dual focus is innovative in a space where most interventions treat these issues in isolation.
Findings, insights and outcomes
Dr Chen discovered a sharp contrast between apps identified through scientific literature and those commonly used in app stores. Apps developed in academic settings were generally theory-driven and designed with clinical rigor, yet they had very limited reach, usage, and visibility in the marketplace. In contrast, commercial apps had high download rates and strong user ratings—but almost none were grounded in behavioral theories or empirical evidence.
Overall, the review revealed not only a lack of effective, scalable tools for this population, but also a missed opportunity to translate evidence-based approaches into accessible, engaging digital interventions.
At a broader level, this project has sparked conversations about equity in digital health, especially for marginalized groups like people with mental health conditions who smoke. By addressing both accessibility and effectiveness, Dr Chen and his team hope to reduce smoking-related health disparities and contribute to more inclusive digital health innovation in New Zealand and beyond.
Benefits of research findings
While the full-scale implementation of the intervention is still in progress, several key end-user groups have already started to benefit from the research findings.
Mental health service users who smoke have been placed at the center of the design process. Through the co-design and formative research stages, participants with lived experience contributed directly to shaping the app’s features, content, and usability. In doing so, they gained early exposure to supportive tools and reported increased awareness of the connection between smoking and mental health—many of them expressing motivation to quit or reduce smoking.
Clinicians and service providers in smoking cessation and mental health care have benefited from the review findings. The compilation of systematic evidence has helped inform decision-making by clearly outlining the gaps in current digital interventions and the limited availability of truly evidence-based tools for their clients.
Researchers and developers in the digital health field have drawn on the work to understand how to better translate theory-driven interventions into user-friendly, scalable apps. The dual-track review methodology—comparing academic and market apps—has already sparked interest in creating more collaborative pipelines between science and commercial health tech sectors.
Moving forward, the pilot trial of the app will provide the foundation for broader roll-out, enabling reach to a wider community of people with mental health challenges who smoke, particularly in underserved populations such as Māori and low-income groups.
Impact of Ember Innovations research funding
The Ember Innovations Research Grant plays a vital role in advancing mental health research by bridging the gap between community need, clinical insight, and innovation.
What sets Ember apart is its focus on equity-driven, user-informed, and solution-focused research—particularly for populations that are often overlooked in mainstream funding cycles.
In this instance, the Ember grant provided not only financial support but also legitimacy and visibility for a project addressing a highly specific but deeply underserved intersection: smoking cessation for people with mental health conditions. Traditional funding sources often hesitate to invest in early-phase or cross-disciplinary digital mental health interventions. Ember’s support enabled researchers to conduct a rigorous systematic review, develop a co-designed app prototype, and prepare for a pilot trial—essential building blocks for long-term impact.
For emerging researchers, Ember’s support also fosters autonomy and innovation. It empowers researchers to take intellectual risks, co-create with communities, and build transdisciplinary collaborations that may not fit neatly into traditional research frameworks.
Ultimately, Ember Innovations Research Grants catalyze real-world impact by funding projects that are grounded in equity and focused on tangible outcomes, making them indispensable in today’s mental health research ecosystem.
