Skip to main content
Springer Nature Link
Log in

A touching app voice thinking about ethics of persuasive technology through an analysis of mobile smoking-cessation apps

  • Original Paper
  • Published:
Ethics and Information Technology Aims and scope Submit manuscript

Abstract

We study smoking-cessation apps in order to formulate a framework for ethical evaluation, analyzing apps as ‘medium’, ‘market’, and ‘genre’. We center on the value of user autonomy through truthfulness and self-understanding. Smoking-cessation apps usually communicate in an anonymous ‘app voice’, with little presence of professional or other identified voices. Because of the fast-and-frugal communication, truthfulness is problematic. Messages in the ‘quantification’ modules may be read as deceitfully accurate. The app voice frames smoking as a useless, damaging habit indicative of weakness of will, in a ‘cold-turkey’ frame of individual mind-over-body heroism. Thus apps contribute to a stigmatization of smokers and culpabilization of relapses. The potential to support user autonomy through diverse meaningful voices and personalized communication remains yet unused.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Abroms, L. C., Lee Westmaas, J., Bontemps-Jones, J., Ramani, R., & Mellerson, J. (2013). A content analysis of popular smartphone apps for smoking cessation. American Journal of Preventive Medicine, 45(6), 732–736. doi:10.1016/j.amepre.2013.07.008.

    Article  Google Scholar 

  • Abroms, L., Padmanabhan, N., Thaweethai, L., & Phillips, T. (2011). iPhone apps for smoking cessation: A content analysis. American Journal of Preventive Medicine, 40(3), 279–285.

    Article  Google Scholar 

  • Atkinson, B. M. C. (2006). Captology: A critical review. In W. Ijsselsteijn, Y. de Kort, & E. van den Hoven (Eds.), Persuasive technology. Lecture notes in computer science (Vol. 3962, pp. 171–182). Berlin: Springer.

    Google Scholar 

  • Bakhtin, M. M. (1981). The dialogical imagination: Four essays. In M. Holquist (Ed.) Austin: University of Texas Press.

  • Bakhtin, M. (1984). Problems of Dostoevsky’s poetics. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Berdichevsky, D., & Neuenschwander, E. (1999). Toward an ethics of persuasive technology. Communications of the ACM, 42(5), 51–58. doi:10.1145/301353.301410.

    Article  Google Scholar 

  • BinDhim, N. F., McGeechan, K., & Trevena, L. (2014). Who uses smoking cessation apps? A feasibility study across three countries via smartphones [Online]. JMIR mHealth and uHealth, 2(1). Available from: http://mhealth.jmir.org. Accessed 6 Dec 2015.

  • Bolt, D. M., Piper, M. E., McCarthy, D. E., Japuntich, S. J., Fiore, M. C., Smith, S. S., & Baker, T. B. (2009). The Wisconsin predicting patients’ relapse questionnaire. Nicotine & Tobacco Research, 11(5), 481–492.

    Article  Google Scholar 

  • Bottorff, J. L., Oliffe, J., Kalaw, C., Carey, J., & Mroz, L. (2006). Men’s constructions of smoking in the context of women’s tobacco reduction during pregnancy and postpartum. Social Science and Medicine, 62(12), 3096–3108.

    Article  Google Scholar 

  • Breland, J. Y., Yeh, V. M., & Yu, J. (2013). Adherence to evidence-based guidelines among diabetes self-management apps. Translational Behavioral Medicine, 3(3), 277–286.

    Article  Google Scholar 

  • Brown, I., & Adams, A. A. (2007). The ethical challenges of ubiquitous healthcare. International Review of Information Ethics, 8, 53–60.

    Google Scholar 

  • Choi, J., Noh, G.-Y., & Park, D.-J. (2014). Smoking cessation apps for smartphones: Content analysis with the self-determination theory. Journal of Medical Internet Research, 16(2), e44. doi:10.2196/jmir.3061.

    Article  Google Scholar 

  • Cohn, A., Hunter-Reel, D., Hagman, B., & Mitchell, J. (2011). Promoting behavior change from alcohol use through mobile technology: The future of ecological momentary assessment. Alcoholism, Clinical and Experimental Research, 35(12), 2209–2215.

    Article  Google Scholar 

  • Conrad, P. (1992). Medicalization and social control. Annual Review of Sociology, 18, 209–232.

    Article  Google Scholar 

  • Courtwright, A. (2013). Stigmatization and public health ethics. Bioethics, 27(2), 74–80.

    Article  Google Scholar 

  • Cowan, L. T., Van Wagenen, S. A., Brown, B. A., Hedin, R. J., Seino-Stephan, Y., Hall, P. C., & West, J. H. (2013). Apps of steel: Are exercise apps providing consumers with realistic expectations? A content analysis of exercise apps for presence of behavior change theory. Health Education and Behavior: The Official Publication of the Society for Public Health Education, 40(2), 133–139.

    Article  Google Scholar 

  • Desantis, A. D. (2003). A couple of white guys sitting around talking: The collective rationalization of cigar smoking. Journal of Contemporary Ethnography, 32(4), 432–466.

    Article  MathSciNet  Google Scholar 

  • Ellison, N. B., Hancock, J. T., & Toma, C. L. (2011). Profile as promise: A framework for conceptualizing veracity in online dating self-presentations. New Media and Society, 14(1), 45–62. doi:10.1177/1461444811410395.

    Article  Google Scholar 

  • Engestrom, R. (1995). Voice as communicative action. Mind, Culture, and Activity, 2(3), 192–214.

    Article  Google Scholar 

  • Etter, J.-F., Le Houezec, J., & Perneger, T. (2003). A self-administered questionnaire to measure dependence on cigarettes: The cigarette dependence scale. Neuropsychopharmacology, 28, 359–370.

    Article  Google Scholar 

  • Fogg, B. (1998). Persuasive computers. In Proceedings of the SIGCHI conference on human factors in computing systems—CHI’98 (pp. 225–232). New York, NY: ACM Press. doi:10.1145/274644.274677

  • Fogg, B. J. (2009). Creating persuasive technologies: An eight-step design process. In Persuasive’09 (pp. 1–6). Claremont, CA.

  • Friedman, B. (1996). Value-sensitive design. Interactions, 3(6), 16–23. doi:10.1145/242485.242493.

    Article  Google Scholar 

  • Friedman, B., Kahn, P. H., & Borning, A. (2008). Value sensitive design and information systems. In K. E. Himma & H. T. Tavani (Eds.), The handbook of information and computer ethics (pp. 69–101). Hoboken, NJ: Wiley.

    Chapter  Google Scholar 

  • Fry, G., Grogan, S., Gough, B., & Conner, M. (2008). Smoking in the lived world: How young people make sense of the social role cigarettes play in their lives. The British Journal of Social Psychology, 47(Pt 4), 763–780.

    Article  Google Scholar 

  • Gavriluţă, N. (2002). On tolerance and acceptance of the other. Journal for the Study of Religions and Ideologies, 3, 22–27.

    Google Scholar 

  • Guttman, N., & Salmon, C. T. (2004). Guilt, fear, stigma and knowledge gaps: Ethical issues in public health communication interventions. Bioethics, 18(6), 531–552.

    Article  Google Scholar 

  • Hoeppner, B. B., Hoeppner, S. S., Seaboyer, L., Schick, M. R., Wu, G. W. Y., Bergman, B. G., et al. (2015). How smart are smartphone apps for smoking cessation? A content analysis. Nicotine and Tobacco Research. doi:10.1093/ntr/ntv117.

  • Klasnja, P., & Pratt, W. (2012). Healthcare in the pocket: Mapping the space of mobile-phone health interventions. Journal of Biomedical Informatics, 45(1), 184–198.

    Article  Google Scholar 

  • Lawn, S. J., Pols, R. G., & Barber, J. G. (2002). Smoking and quitting: A qualitative study with community-living psychiatric clients. Social Science and Medicine, 54(1), 93–104.

    Article  Google Scholar 

  • Lessig, L. (2000). Code is law. On liberty in cyberspace [Online]. Harvard Magazine. Available from http://harvardmagazine.com. Accessed 15 Nov 2013.

  • Lewis, B. (2006). Listening to Chekhov: Narrative approaches to depression. Literature and Medicine, 25(1), 46–71.

    Article  Google Scholar 

  • Lockton, D., Harrinson, D., & Stanton, N. (2008). Design with intent: Persuasive technology in a wider context. Lecture Notes in Computer Science, 5033, 274–278.

    Article  Google Scholar 

  • Lupton, D. (2013). Quantifying the body: Monitoring and measuring health in the age of mHealth technologies. Critical Public Health, 23(4), 393–403.

    Article  Google Scholar 

  • Macnaughton, J., Carro-Ripalda, S., & Russell, A. (2012). “Risking enchantment”: How are we to view the smoking person? Critical Public Health, 22(4), 455–469.

    Article  Google Scholar 

  • Matei, Ş., Rughiniş, C., & Rughiniş, R. (2014). Refreshing quantification and other ploys to give up the habit a repertoire of relations, identities, and rhetorical devices in smoking cessation applications. In The 16th international conference on human–computer interaction HCII 2014. Applications and services lecture notes in computer science volume 8512 (pp. 265–276). Crete, Greece: Springer, Berlin.

  • Meier, E., Tackett, A. P., & Wagener, T. L. (2013). Effectiveness of electronic aids for smoking cessation. Current Cardiovascular Risk Reports, 7(6), 464–472.

    Article  Google Scholar 

  • Mosa, A. S. M., Yoo, I., & Sheets, L. (2012). A systematic review of healthcare applications for smartphones. BMC Medical Informatics and Decision Making, 12(1), 67.

    Article  Google Scholar 

  • Nafus, D., & Sherman, J. (2014). This one does not go up to 11: The quantified self movement as an alternative big data practice. International Journal of Communication, 8, 1784–1794.

    Google Scholar 

  • Pagoto, S., Schneider, K., Jojic, M., DeBiasse, M., & Mann, D. (2013). Evidence-based strategies in weight-loss mobile apps. American Journal of Preventive Medicine, 45(5), 576–582.

    Article  Google Scholar 

  • Puustinen, R. (2000). Voices to be heard—The many positions of a physician in Anton Chekhov’s short story, a case history. Journal of Medical Ethics: Medical Humanities, 26, 37–42.

    Article  Google Scholar 

  • Rughiniş, R., Matei, Ş., & Rughiniş, C. (2014). Smoking does not make you happy. Unlearning smoking habits through mobile applications on android OS. In The 6th international conference on computer supported education CSEDU 2014. Barcelona: INSTICC.

  • Rughiniş, C., & Rughiniş, R. (2014). Influence of daily smoking frequency on passive smoking behaviors and beliefs: Implications for self tracking practices and mobile applications. Revista de Cercetare şi Intervenţie Socială, 44, 116–131.

    Google Scholar 

  • Smith, S. S., Piper, M. E., Bolt, D. M., Fiore, M. C., Wetter, D. W., Cincciripini, P. M., & Baker, T. B. (2010). Development of the brief Wisconsin inventory of smoking dependence motives. Nicotine & Tobacco Research, 12(5), 489–499.

    Article  Google Scholar 

  • Spahn, A. (2012). And lead us (not) into persuasion…? Persuasive technology and the ethics of communication. Science and Engineering Ethics, 18(4), 633–650. doi:10.1007/s11948-011-9278-y.

    Article  Google Scholar 

  • Thaler, R. H., Sunstein, C. R., & Balz, J. P. (2010). Choice architecture [Online]. SSRN Electronic Journal. Availabe from http://ssrn.com. Accessed 6 Dec 2015.

  • Ubhi, H. K., Michie, S., Kotz, D., Wong, W. C., & West, R. (2015). A mobile app to aid smoking cessation: Preliminary evaluation of SmokeFree28 [Online]. Journal of Medical Internet Research, 17(1). Available from: http://www.jmir.org. Accessed 6 Dec 2015.

  • Van Singer, M., Chatton, A., & Khazaal, Y. (2015). Quality of smartphone apps related to panic disorder. Frontiers in Psychiatry, 6, 1–7. doi:10.3389/fpsyt.2015.00096.

    Google Scholar 

  • Verbeek, P.-P. (2006). Persuasive technology and moral responsibility. Toward an ethical framework for persuasive technologies. Persuasive, 6, 1–15.

  • Verbeek, P.-P. (2008). Obstetric ultrasound and the technological mediation of morality: A postphenomenological analysis. Human Studies, 31(1), 11–26.

    Article  Google Scholar 

  • Wellman, R. J., Di Franza, J. R., Morgenstern, M., Hanewinkel, R., Isensee, B., & Sabiston, C. M. (2011). Psychometric properties of the autonomy over tobacco scale in German. European Addiction Research, 18, 76–82.

    Article  Google Scholar 

  • Welsch, S. K., Smith, S. S., Wetter, D. W., Jorenby, D. E., Fiore, M. C., & Baker, T. B. (1999). Development and validation of the wisconsin smoking withdrawal scale. Experimental and Clinical Psychopharmacology, 7(4), 354–361.

    Article  Google Scholar 

  • Wertsch, J. V. (1993). Voices of the mind. A sociocultural approach to mediated action. Cambridge, MA: Harvard University Press.

    Google Scholar 

Download references

Acknowledgments

This article has been supported by the research project “Sociological imagination and disciplinary orientation in applied social research” (http://igel.ro), taking place in The Research Center in Human Resources, Management and Marketing of the Department of Sociology and Social Work, University of Bucharest, with the financial support of UEFISCDI with Grant No. PN-II-RU-TE-2011-3-0143, contract 14/28.10.2011.

Author information

Authors and Affiliations

  1. Department of Sociology, University of Bucharest, Bucharest, Romania

    Cosima Rughiniş & Ştefania Matei

  2. Department of Computer Science, University Politehnica of Bucharest, Bucharest, Romania

    Răzvan Rughiniş

Authors
  1. Cosima Rughiniş
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Răzvan Rughiniş
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Ştefania Matei
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Ştefania Matei.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rughiniş, C., Rughiniş, R. & Matei, Ş. A touching app voice thinking about ethics of persuasive technology through an analysis of mobile smoking-cessation apps. Ethics Inf Technol 17, 295–309 (2015). https://doi.org/10.1007/s10676-016-9385-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10676-016-9385-1

Keywords