Ninan, a thoracic surgeon at Centennial Medical Center, prescribed a smartphone app with a whole toolbox of information to help people toss away their cigarettes for good. It even has a link to a Facebook support group.
"He was the ideal candidate," Ninan said. "He's always got his iPhone in his left hand."
The app, developed at the University of Tennessee Health Science Center in Memphis, is just one example of the ways that cellular phones have changed medicine.
Doctors use smartphones for medical reference, for quick information exchanges and for calculations related to diagnostic tests and treatments. Disease experts even tracked the spread of cholera in Haiti by monitoring population movement through cellphone traffic.
Besides the app to quit smoking, there also are apps for weight loss, pregnancy and diabetes.
Ninan, an avid smartphone user, said the device has quickly become "an invaluable part of my medical everyday existence." He and other physicians sometimes send text messages about specific patient cases, using only the patients' initials, to give one another a heads-up to check the official electronic health records.
"To think about calling up another physician and spending 10 minutes on the phone — how many people can you do that with when you are seeing 30 patients a day or operating on five patients a day?" Ninan said. "Now, I can just walk out of the operating room and text three physicians who are involved with the patient."
The increased use of smartphones by doctors has caused the U.S. Food and Drug Administration to consider oversight of some of these applications. However, information sharing regarding patients is not among applications the FDA may regulate, according to draft guidelines released in July.
The requirements would cover when the phones are used as an accessory to an already regulated medical device or when the application would, in essence, transform the smartphone into such a device. For example, an app that allows doctors to view medical images for diagnostic purposes would have to be cleared by the FDA in the same manner as the device that created the images.
Self-help programs, such as the "Quit Forever App" for smokers, would not fall under the FDA's purview. Launched this summer, it costs $1.99 to download, with no recurring fees. At present, it is available only on the iPhone, but the University of Tennessee Health Science Center expects to introduce an Android-compatible version in the next year to year and a half.
In Tennessee, smokers account for almost one-fifth of young adults between ages 18 and 24 and more than one-fourth of those 25 to 44, according to the U.S. Centers for Disease Control and Prevention.
"We need to target young people in a very appropriate format," Ninan said. "It is surprising what providing them with the appropriate resources can do."
Younger people tend to be early adapters of new technologies, but more 60-somethings are getting smartphones. Cristina Romine, a "Freedom From Smoking" facilitator with the American Lung Association, often works with this age group. At present, she has only one patient using the app.
"It's basically the whole 'Freedom From Smoking' program on your iPhone," Romine said. "It has all the workbooks that we use in the actual classes ... your triggers, every situation that you go through during quitting smoking."
She believes the Facebook link is especially beneficial.
"There's other people out there that you might be able to interact with to get the support group that you would normally get in a physical session," she said.