Table 1.
Expert panel themes. Each of the insights of our expert panel are organized by a question and accompanied by a short description.
| Questions and themes | Description | |
| Question 1: What are the biggest challenges for people with serious mental illness to quit smoking? | ||
| Motivation to quit | Life expectancy is not generally a motivation to quit in this population | |
| Quitting without preparation | Early attempts to quit without enough preparation, and/or lacking a step-down quitting process | |
| Withdrawal symptoms | Fear of experiencing withdrawal symptoms days after quitting | |
| Mental health symptoms | Ongoing anxiety, depression, stress, and psychotic symptoms during the quitting process | |
| Question 2: How could we design a highly engaging app for smokers with serious mental illness? | ||
| Meaningful visuals | The ability to display pictures of inspiring objects, people, sites, or pets | |
| Having a “video game” feel | The appeal of video games or “game like” features (eg, “bingo”) | |
| Social networking | The possibility of sharing with peers | |
| Storytelling | The use of interactive characters (eg, dog) for storytelling | |
| Encouraging activation | The importance of increasing activation (eg, exercise) to facilitate quitting and cope with withdrawal | |
| Progressive disclosure | Unlocking bits and pieces of the app, such as a picture or a message, as the user makes progress | |
| Rewarding small victories | Reinforcing small victories toward quitting (eg, one day without smoking) | |
| Money savings motivation | Small money savings (eg, a few extra dollars a week) | |
| Medication aids | Medication education and a system to help patients adhere to medication intake | |
| Miscellaneous themes | ||
| Technological literacy | Lack of smartphone knowledge was viewed as a potential barrier to app use | |
| Predominant use of Android | The need to build an app in Android was viewed as important to secure access in this population | |
| Provider check-ins | Flexible check-ins (eg, text messages) were emphasized to enhance engagement with the app | |
| Need for personalization | An app that was customizable to each patient was deemed as important | |
| Stealing | Concern that some patients with serious mental illness might have their devices stolen | |