Adherence of popular smoking cessation mobile applications to evidence-based guidelines

Abstract

Background Smoking remains one of the major preventable causes of chronic diseases. Considering the promising evidence on the effectiveness of mobile technology for health behaviour change, along with the increasing adoption of smartphones, this review aims to systematically assess the adherence of popular mobile apps for smoking cessation to evidence-based guidelines. Methods The United Kingdom Android and iOS markets were searched in February 2018 to identify smoking cessation apps. After screening, 125 Android and 15 iOS apps were tested independently by two reviewers for adherence to the National Institute of Care and Excellence (NICE) Smoking Cessation Guidelines for Self-Help Materials and the Five A Guidelines for Smoking Cessation. Pearson chi square tests were run to examine differences between the two operating systems. Results A majority of apps across both operating systems had low adherence (fulfils 1–2 out of 5 guidelines) to the Five A Guidelines (65.7%) and low adherence (fulfils 1–3 out of 9 guidelines) to the NICE Smoking Cessation Guidelines for Self-Help Materials (63.6%). Only 15% of mobile apps provided information about the benefits of nicotine replacement therapy (NRT), and even fewer provided information regarding types of NRT products (7.1%) or how to use them (2.1%). In addition, only a minority of apps arrange follow-up appointments or provide additional support to help smokers quit. Conclusion Similar to previous mobile app reviews dating back to 2014, our findings show that most mobile apps do not follow existing smoking cessation treatment guidelines, indicating little change regarding the availability of evidence-based mobile apps for smoking cessation in the UK market. Smokers seeking to quit, tobacco control policy makers and software developers need to work together to develop apps that are in line with the latest clinical guidelines and strategies to maximise effectiveness. Electronic supplementary material The online version of this article (10.1186/s12889-019-7084-7) contains supplementary material, which is available to authorized users.

Behavior Change Techniques in Popular Mobile Apps for Smoking Cessation in France: Content Analysis

“…Indeed, 252 apps were identified in the US market in 2013 [11] and 225 apps were identified in 2016 [14]. Similar to these findings, 112 apps were examined in Australia [15] and 140 apps in England [16]. Consequently, even if several apps are available on the market, they are not accessible to most of the native French-speaking population speaking only French.…”

“…Indeed, all apps studied in the Cochrane review used different cognitive and behavioral theories as their point of departure [12,13]. The "active ingredients" (a term used to encapsulate the various strategies and practices of evidence-based behavioral and cognitive therapies) of strategies that have withstood clinical study and peer review and that are often recommended by public health authorities for clinical practice are not well integrated into the various apps available, whether in the American [11,14], Australian [15], or British [16] market. Moreover, even if an app includes all the therapeutic guidelines, it might not be used; thus, its effectiveness would be limited.…”

Self-Efficacy and Motivation to Quit of Smokers Seeking to Quit: Quantitative Assessment of Smoking Cessation Mobile Apps

“…Participants with even-numbered PIDs were assigned to the mobile app Quit Genius, and participants with odd-numbered PIDs were assigned to the mobile app Kwit. As the analysis presented in this paper is from a broader study investigating the impact of gamification, both apps were chosen based on their embedment of gamification features and adherence to cessation guidelines in the United Kingdom [ 25 ]. More specifically, the mobile apps were chosen based on a comprehensive review of smoking cessation mobile apps available on the UK Android and iOS market [ 25 ].…”

Effectiveness of mobile applications to quit smoking: Systematic review and meta-analysis

“…Even though some studies with protocols of clinical trials have been published to evaluate the effectiveness of mobile applications compared to other alternatives 36 - 39 , the trials are still in progress, and therefore the results have not been included in the meta-analysis. In addition, as the adherence to smoking cessation treatment guidelines is generally low, this may potentially have a negative impact on the effectiveness of apps 46 . On the other hand, and focusing on the usefulness of health app use, there are several patient characteristics that make the difference.…”