Can a smoking cessation app benefit individuals in disadvantaged areas? A qualitative study on motivation, barriers, and perceptions of a digital app.

Objective: In Sweden, the prevalence of daily smoking has decreased substantially over the past few decades. However, a socioeconomic divide is evident, contributing to health inequities. The current study focuses on the needs, facilitators, and barriers in relation to quitting smoking among individuals in disadvantaged areas and explores their perception of digital tools for smoking cessation. Method: Semi-structured interviews were conducted with 30 participants in Stockholm County between 2022 and 2023. Participants were recruited through health care centres, dental clinics, and civil society actors. A thematic analysis was performed. Results: Two cross-cutting main themes were identified; 1) Motivational factors and barriers in smoking cessation, including the subthemes "health, concern for loved ones and economic aspects" and "emotional, environmental, and cultural barriers" and 2) Benefits and limitations of a digital tool for smoking cessation, including the subthemes"important/relevant features in a digital app" and "limitations of digital support". Conclusions: The results reveal that most participants want to quit smoking but perceive it as difficult. The study highlights the importance of addressing social disparities in smoking and the need for accessible smoking cessation support. While mobile apps are viewed as promising for smoking cessation by some of the participants, scepticism exists among others. Moving forward, personalized approaches that integrate digital tools with traditional methods for smoking cessation can be important to reduce smoking prevalence. Ensuring accessibility of effective smoking cessation support for all is a key public health interest.