Smartphone apps compared for smoking cessation
Patients using a smartphone application for smoking cessation based on coping skills had a nearly 1.5 times higher odds of quitting smoking compared with those who used an app that teaches avoiding triggers for smoking.
A smartphone application based on acceptance and commitment therapy was more efficacious for stopping smoking than a guideline-based app that teaches avoidance of smoking triggers, a study found.
Researchers evaluated the efficacy of a newly developed app for smoking cessation based on acceptance and commitment therapy by comparing it to an app from the National Cancer Institute that is based on U.S. clinical practice guidelines. iCanQuit is a proprietary app created for the study that guides users through eight levels of self-help, teaching skills for coping with smoking urges, staying motivated, and preventing relapse. It is not yet available to the public. The National Cancer Institute QuitGuide is freely available and teaches avoiding smoking triggers with four sections: thinking about quitting, preparing to quit, quitting, and staying quit.
The primary outcome was self-reported 30-day point prevalence abstinence (PPA) at 12 months. Secondary outcomes were seven-day PPA at 12 months, prolonged abstinence, 30-day and seven-day PPA at three and six months after randomization, and cessation of all tobacco products (including e-cigarettes) at 12 months after randomization. Results were published by JAMA Internal Medicine on Sept. 21.
A total of 2,415 adult cigarette smokers were randomly assigned, 1,214 to the new app and 1,201 to the guideline app. For the primary outcome of 30-day PPA at the 12-month follow-up, odds of quitting were 1.49 times higher among iCanQuit participants than among QuitGuide participants (28.2% vs. 21.1%; odds ratio [OR], 1.49 [95% CI, 1.22 to 1.83]; P<0.001). The new app also significantly outperformed the guideline-based app on a number of other outcomes:
- seven-day PPA at 12-month follow-up (OR, 1.35; 95% CI, 1.12 to 1.63; P=0.002),
- prolonged abstinence at 12-month follow-up (OR, 2.00; 95% CI, 1.45 to 2.76; P<0.001),
- abstinence from all tobacco products (including e-cigarettes) at 12-month follow-up (OR, 1.60; 95% CI, 1.28 to 1.99; P<0.001),
- 30-day PPA at three-month follow-up (OR, 2.20; 95% CI, 1.68 to 2.89; P<0.001),
- 30-day PPA at six-month follow-up (OR, 2.03; 95% CI, 1.63 to 2.54; P<0.001),
- seven-day PPA at three-month follow-up (OR, 2.04; 95% CI, 1.64 to 2.54; P<0.001), and
- seven-day PPA at six-month follow-up (OR, 1.73; 95% CI, 1.42 to 2.10; P<0.001).
“iCanQuit can be an impactful treatment option; based on the main result, for every 100,000 smokers reached with iCanQuit, 28,000 would quit smoking,” the authors wrote. They called for additional research to explore why the new app was more efficacious than the guideline-based app.