Digital Smoking Cessation Preferences of Predominately Low-Income and Latino Residents of the San Joaquin Valley in California: Qualitative Study
Background: Although rates of tobacco use in California have declined overall, adults in the San Joaquin Valley (SJV), particularly Hispanic/Latinos (“Latinos”), have disproportionately high rates of tobacco use, tobacco-related illness, and mortality. Residents of the SJV also have limited access to cessation support services, and need accessible, non-clinical alternatives. Given high smartphone use rates among Latinos and residents of rural communities, digital health tools may present an accessible approach to expand cessation support. Objective: This study explored tobacco use behaviors, cessation experiences, and views about digital cessation tools for tobacco cessation among SJV residents. The secondary objective was to assess the appeal, #usability, and necessary adaptations of two existing digital smoking cessation tools—a smoking cessation app and a social media-based intervention. Methods: Through a SJV-based academic-community partnership, we recruited 29 predominantly Latino adults who reported current smoking. We conducted four focus groups (two English, two Spanish) to explore tobacco use and cessation experiences, and preferences for smoking cessation tools. Nine participants subsequently completed in-depth interviews where they viewed videos describing two digital smoking cessation tools — a cessation app and a social media intervention — to assess their appeal and #usability. Results: Most participants were motivated to quit despite experiencing barriers, emphasizing the need for culturally tailored digital cessation tools to enhance engagement. They preferred interventions that integrated culturally relevant content reflecting lived experiences, featured language-concordant communications, and provided social supports, such as chat rooms for peer connection. While participants appreciated the app’s private interface and comprehensive curriculum, the social-media based program was favored for its engaging design, despite privacy concerns. Preferences for specific interventions varied by age and digital literacy. Material rewards increased appeal to use both digital health tools to quit smoking. Conclusions: This sample of predominantly Latino adults from the SJV expressed favorable interest in digital cessation support, yet existing tools require adaptation to improve cultural relevance, accessibility, and #usability. Participants emphasized language-concordant services, representation from people with lived experience, and community-building features. While digital interventions were well received, privacy concerns and digital literacy barriers must be addressed to enhance engagement.
