Smoking cessation interventions are effective, but they are not easily accessible for all treatment-seeking smokers. Mobile health (mHealth) apps have been used in recent years to overcome some of these limitations. Smoking cessation apps can be used in combination with a face-to-face intervention (FFSC-Apps), or alone as general apps (GSC-Apps). The aims of this review were (1) to examine the effects of FFSC-Apps and GSC-Apps on abstinence, tobacco use, and relapse rates; and (2) to describe their features. A systematic review was conducted following the internationally Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of the total 6016 studies screened, 24 were included, of which nine used GSC-Apps and 15 FFSC-Apps. Eight studies reported significant differences between conditions in smoking cessation outcomes, with three of them being in favor of the use of apps, and two between different point-assessments. Concerning Apps features, most GSC-Apps included self-tracking and setting a quit plan, whereas most of the FFSC-Apps included self-tracking and carbon monoxide (CO) measures. Smartphone apps for smoking cessation could be promising tools. However, more research with an adequate methodological quality is needed to determine its effect. Nevertheless, smartphone apps’ high availability and attractiveness represent a great opportunity to reach large populations.
Despite the fact that perceived stress is related to abstinence smoking outcomes, no studies have investigated the mediational effect of specific tobacco-related variables on this relationship. This study aimed to explore the indirect effect of perceived stress on abstinence at the end of treatment through smoking urges. The sample comprised 260 treatment-seeking smokers (58.5% female; Mage = 46.00; SD = 11.1) who underwent psychological smoking cessation treatment. The brief version of the Questionnaire of Smoking Urges (QSU) and the Perceived Stress Scale (PSS14) were used. Mediation analyses were conducted in which smoking urges and their dimensions were potential mediators in the relationship between perceived stress and abstinence at the end of treatment. The results showed a non-significant direct effect of perceived stress on abstinence. However, a significant indirect effect was found through smoking urges (QSU-total) and, specifically, through smoking urges associated with the expectation of negative affect relief (QSU-Factor 2). A non-significant indirect effect through smoking urges related to the expectation of tobacco use as a pleasurable experience (QSU-Factor 1) was also found. Analyzing possible mediator variables could contribute to understanding previous conflicting data. These findings point to potential interest in including treatment components targeting perceived stress and smoking urges to improve the effectiveness of smoking cessation treatments.
Numerous studies have shown the efficacy of smoking cessation interventions. However, some challenges, such as relapse rates, remain. The availability of information technologies (ICTs) offers promising opportunities to address such challenges. The aim of this paper is to describe the protocol followed to assess the efficacy of a face-to-face cognitive–behavioral intervention for smoking cessation using a smartphone application as a complement, compared with a control group. A single blind, two-arm, randomized controlled trial is proposed (NCT04765813). The participants will be smokers over 18 years old, who smoke at least eight cigarettes per day. Participants will be randomized to one of two conditions, using a 1:1 allocation ratio: (1) cognitive–behavioral smoking cessation treatment along with an App with active therapeutic components (SinHumo App); or (2) cognitive–behavioral treatment along with the use of a control App (without active components). The experimental App will be used during the eight treatment sessions and for 12 months after the end of treatment. The primary outcome measures will be 7-days point-prevalence abstinence at 12-months follow-up. We expect the experimental App to obtain higher abstinence rates at the end of treatment and at one-year post-treatment follow-ups and lower relapse rates, compared to the control App.
BACKGROUND Behavioural interventions are effective for smoking cessation. However, they are not easily accessible for all treatment-seeking smokers. ICT (Information and Communication Technology) and, specifically, mobile health (mHealth) apps, have been used in recent years to overcome these limitations. Smoking cessation apps can be used combined with a face-to-face intervention (FFSC-Apps) or as general apps (GSC-Apps). OBJECTIVE The aims of this review were (1) to examine the effects of FFSC-Apps and GSC-Apps on abstinence, tobacco use, and relapse rates, and (2) to describe their features. METHODS A systematic review was conducted following the internationally Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, using MEDLINE and PsycINFO databases to identify papers published up to 30th November 2020. RESULTS Of the total 6014 studies screened, 22 were included in this review, of which eight used GSC-Apps and 14 FFSC-Apps. Of the 22 studies, seven were randomized controlled trials (RCTs), four controlled clinical trials (CCTs), and 11 before-and-after studies. Also, 11 of the 22 studies were pilot studies. Regarding study quality, five were rated as strong, 12 as moderate, and five as weak. Regarding smoking cessation outcomes, two GSC-Apps studies obtained significant differences between conditions in abstinence rates (one of them obtained higher rates in the app condition) and two in cigarettes per day (CPD), with higher reduction rates in the app condition. None of the FFSC-Apps studies obtained significant differences in abstinence rates between conditions but two FFSC-Apps studies showed significant differences in abstinence rates at the different point-assessments. None of the included studies provided information about smoking relapse rates. Concerning apps features, the most frequently used in the FFSC-Apps studies were self-tracking and carbon monoxide (CO) measures and, in the GSC-Apps studies, they were self-tracking, setting a quit plan/quit date, motivational content, and smoking self-report. CONCLUSIONS Smartphone apps for smoking cessation are promising tools for quitting smoking. Although research in this area is at an early stage and more studies are needed to establish their efficacy, the high availability and usage of smartphone apps imply a great opportunity to complement traditional smoking cessation interventions and to reach large populations. In terms of public health, even if these interventions had a small effect size, they could have a relevant impact on improving health and reducing economic costs related to tobacco use. CLINICALTRIAL PROSPERO CRD42020154272; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020154272
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