Efficacy of Smartphone Applications for Smoking Cessation

Bricker, Jonathan B.; Watson, Noreen L; Mull, Kristin E.; Sullivan, Brianna M.; Heffner, Jaimee L.

doi:10.1001/jamainternmed.2020.4055

Cited by 151 publications

(171 citation statements)

References 38 publications

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“…We did not find comparable data in studies that included interventions similar to Pivot. Broadening the scope to include additional digital smoking cessation interventions, 6-month 30-day PPA outcomes ranged from 12.9% to 21.8%, with an additional study reporting a 26.2% 30-day PPA rate at 8 weeks [10,34,40]. Similar to our expectation, we believe that the additional features of Pivot beyond the app likely contributed to the higher 30-day PPA rate.…”

Section: Ppa Ratessupporting

confidence: 74%

“…Looking more broadly at outcomes from digital smoking cessation interventions, 7-day PPA at 6 months range from 9.8% to 29.6%, with most falling between 17% and 25% [10,37,38,40,41]. Our higher 7-day PPA rate of 35.4% aligns with expectations considering Pivot's additional features of the personal breath sensor and coaching.…”

Section: Ppa Ratessupporting

confidence: 60%

“…This assessment provided no evidence that smartphone apps improved the likelihood of smoking cessation (RR 1.00, 95% CI 0.66-1.52; I 2 = 59%), but the authors noted that the evaluated evidence was of very low certainty due to inconsistency and imprecision, highlighting the need for more randomized controlled trials (RCTs) in this area. More recently, Bricker et al [10] performed an RCT comparing an acceptance and commitment therapy-based smoking cessation smartphone app (iCanQuit, n=1214) with a United States Clinical Practice Guideline (USCPG)-based app (QuitGuide, n=1201). At 12 months after randomization, iCanQuit participants had 1.49 times higher odds of quitting smoking compared with that of QuitGuide participants (28.2%, 293/1040 vs 21.1%, 225/1067; odds ratio [OR] 1.49, 95% CI 1.22-1.83; P<.001).…”

Section: Introductionmentioning

confidence: 99%

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Durability of Abstinence After Completing a Comprehensive Digital Smoking Cessation Program Incorporating a Mobile App, Breath Sensor, and Coaching: Cohort Study

Marler¹,

Fujii²,

Galanko³

et al. 2021

J Med Internet Res

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Background Despite decreasing prevalence over the last several decades, cigarette smoking remains the leading cause of preventable death and disease, underscoring the need for innovative, effective solutions. Pivot is a novel, inclusive smoking cessation program designed for smokers along the entire spectrum of readiness to quit. Pivot leverages proven methods and technological advancements, including a personal portable breath carbon monoxide sensor, smartphone app, and in-app text-based coaching. We previously reported outcomes from the end of active Pivot program participation in 319 adult smokers. Herein, we report longer-term follow up in this cohort. Objective The aim of this study was to assess and report participant outcomes 3 months after completion of Pivot, including smoking behavior, quit rates, continuous abstinence rates and durability, and predictors of abstinence. Methods This prospective remote cohort study included US-based cigarette smokers aged 18 to 65 years who smoked ≥5 cigarettes per day (CPD). Three months after completion of active participation in Pivot, final follow-up data were collected via an online questionnaire. Outcomes included smoking behavior (CPD and quit attempts), self-reported quit rates (7- and 30-day point prevalence abstinence [PPA]), and continuous abstinence rates (proportion who achieved uninterrupted abstinence) and duration. Exploratory regression analyses were performed to identify baseline characteristics associated with achievement of 7-day PPA, 30-day PPA, and continuous abstinence. Results A total of 319 participants completed onboarding (intention-to-treat [ITT]); 288/319 participants (90.3%) completed follow up (completers) at a mean of 7.2 (SD 1.2) months after onboarding. At final follow up, CPD were reduced by 52.6% (SE 2.1; P<.001) among all 319 participants, and most completers (152/288, 52.8%) reduced their CPD by at least 50%. Overall, most completers (232/288, 80.6%) made at least one quit attempt. Quit rates increased after the end of Pivot; using ITT analyses, 35.4% (113/319) achieved 7-day PPA and 31.3% (100/319) achieved 30-day PPA at final follow up compared with 32.0% (102/319) and 27.6% (88/319), respectively, at the end of the Pivot program. Continuous abstinence was achieved in about a quarter of those who onboarded (76/319, 23.8%) and in most who reported 30-day PPA at the end of Pivot (76/88, 86.4%), with a mean abstinence duration of 5.8 (SD 0.6) months. In exploratory regression analyses, lower baseline CPD, more positive baseline attitudes reflecting higher self-efficacy (higher confidence to quit and lower perceived difficulty of quitting), and higher education were associated with achieving abstinence. Conclusions This study provides the first longer-term outcomes of the Pivot smoking cessation program. At final follow up, quit rates increased and continuous abstinence was favorable; the majority who achieved abstinence at the end of Pivot sustained abstinence throughout follow up. Decreases in CPD persisted and most participants made a quit attempt. Overall, final follow-up outcomes were stable or improved when compared to previous outcomes from the end of the program. These findings validate earlier results, and suggest that Pivot is an effective and durable solution for smoking cessation. Trial Registration ClinicalTrials.gov NCT03295643; https://clinicaltrials.gov/ct2/show/NCT03295643

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Section: Ppa Ratessupporting

confidence: 74%

Section: Ppa Ratessupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

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Durability of Abstinence After Completing a Comprehensive Digital Smoking Cessation Program Incorporating a Mobile App, Breath Sensor, and Coaching: Cohort Study

Marler¹,

Fujii²,

Galanko³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

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“…With these measures in place, healthcare systems had to rapidly transition from in-person encounters to remote or virtual care methods [22,23]. To date, digital cessation aids including mobile applications and text message programs have effectively promoted self-efficacy and increased abstinence [24][25][26]. With smoking being one of the main preventable causes of COVID-19 progression, smokers may be more inclined to seek out treatment options at this time.…”

Section: Introductionmentioning

confidence: 99%

Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

Joyce

Styklunas

Rigotti

et al. 2021

IJERPH

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The impact of the COVID-19 pandemic on US adults’ smoking and quitting behaviors is unclear. We explored the impact of COVID-19 on smoking behaviors, risk perceptions, and reactions to text messages during a statewide stay-at-home advisory among primary care patients who were trying to quit. From May–June 2020, we interviewed smokers enrolled in a 12-week, pilot cessation trial providing text messaging and mailed nicotine replacement medication (NCT04020718). Twenty-two individuals (82% white, mean age 55 years), representing 88% of trial participants during the stay-at-home advisory, completed exit interviews; four (18%) of them reported abstinence. Interviews were thematically analyzed by two coders. COVID-19-induced environmental changes had mixed effects, facilitating quitting for some and impeding quitting for others. While stress increased for many, those who quit found ways to cope with stress. Generally, participants felt at risk for COVID-19 complications but not at increased risk of becoming infected. Reactions to COVID-19 and quitting behaviors differed across age groups, older participants reported difficulties coping with isolation (e.g., feeling disappointed when a text message came from the study and not a live person). Findings suggest that cessation interventions addressing stress and boredom are needed during COVID-19, while smokers experiencing isolation may benefit from live-person supports.

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“…Further, promoting tech-driven approach by using quitting smoking apps is more beneficial to increase the odds of quitting success. A randomised clinical trial published recently compared the efficacy of two smartphone applications for smoking cessation, and found that smokers who used the iCanQuit app (teaches acceptance of smoking triggers) had 1.49 times higher odds of quitting smoking compared with those who used the QuitGuide app (depends on avoiding smoking triggers) 34 . This elevates apps as an effective way of quitting smoking, particularly apps that depend on accepting the existence of cravings rather than trying to eliminate them.…”

Section: How Can We Support Smoking Cessation During the Covid-19 Pandemic?mentioning

confidence: 99%

Smoking cessation during COVID-19: the top to-do list

Alqahtani

Aldhahir

Oyelade³

et al. 2021

npj Prim. Care Respir. Med.

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As evidence continues to emerge, our understanding of the relationship between smoking and COVID-19 prognosis is steadily growing. An early outlook from World Health Organisation (WHO) indicates that smokers are more vulnerable to severe COVID-19 disease and are also more likely to be infected, as frequent motions from hand to mouth and sharing of tobacco products such as waterpipes increased the possibility of being infected. In this commentary, we discuss some of the latest evidence on smoking and COVID-19 and emphasise the need to promote the personal and public advantages of smoking cessation during the COVID-19 pandemic.

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Efficacy of Smartphone Applications for Smoking Cessation

Cited by 151 publications

References 38 publications

Durability of Abstinence After Completing a Comprehensive Digital Smoking Cessation Program Incorporating a Mobile App, Breath Sensor, and Coaching: Cohort Study

Durability of Abstinence After Completing a Comprehensive Digital Smoking Cessation Program Incorporating a Mobile App, Breath Sensor, and Coaching: Cohort Study

Quit Experiences among Primary Care Patients Enrolled in a Smoking Cessation Pilot RCT Early in the COVID-19 Pandemic

Smoking cessation during COVID-19: the top to-do list

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