Smoking cessation app improves abstinence rate among adult smokers

Use of the novel application (app) CureApp Smoking Cessation (CASC) results in a significantly higher continuous abstinence rate (CAR) from weeks 9 to 24 compared to the control app, making it a promising tool for smoking cessation treatment, according to a study presented at the American Thoracic Society (ATS) 2019 International Conference.

“CASC is a novel smoking cessation app that is integrated with a mobile carbon monoxide checker,” researchers said.

This randomized, sham-controlled, open-label, multicentre trial was conducted in Japan and recruited 584 adult smokers intending to quit smoking at 31 smoking cessation clinics from October 2017 to January 2018. Participants were assigned 1:1 to either CASC treatment or control app (CTL).

Both groups were enrolled in a 12-week standard smoking cessation programme, which included counselling and pharmacotherapy (varenicline or nicotine patch). The CASC group also used the app for 24 weeks, providing participants with animated video tutorials, interactive chatting with automated guidance system, digital diary and measurements of daily exhaled carbon dioxide levels.

Programme contents were customized based on the initial input of the participants’ profiles. The cloud system allowed physicians to review the participants’ daily progress on a web screen. On the other hand, the CTL group used a control app wherein potentially effective cessation functions were removed.

A biochemically validated CAR from weeks 9 to 24 was the primary outcome, while the secondary outcomes included CAR from weeks 9 to 12 and 9 to 52, and 7-day point prevalence abstinence (PPA) at weeks 4, 8, 12, 24 and 52.

Of the participants, 285 in the CASC group and 287 in the CTL group (74.5 percent male) downloaded the apps and were eligible for analysis. Participants in the CASC group showed significantly higher CAR from weeks 9 to 24 than those in the CTL group (63.9 percent vs 50.5 percent; odds ratio [OR], 1.92, 95 percent CI, 1.33–2.74; p<0.001). [ATS 2019, abstract A7357]

CAR from weeks 9 to 12 were similar in both groups (75.4 percent vs 66.2 percent; OR, 1.86, 1.21–2.84; p=0.004). In addition, the CASC group was superior to the CTL group in 7-day PPA at all time points.

A recent study, which used SMS text messaging interventions on top of a nicotine patch and in-person counselling for homeless smokers, found no significant improvement in smoking abstinence after 8 weeks. [JMIR Mhealth Uhealth 2019;7:e13162]

This result was echoed by an earlier study, which used the same intervention for young smokers with low education levels. An SMS text message intervention did not demonstrate statistically significant short-term effects on smoking cessation, but it did lower cigarette consumption. [J Med Internet Res 2013;15:e171]

“Smoking is the leading cause of preventable death. Smartphone apps for smoking cessation are a promising treatment resource; however, evidence-based apps whose efficacies are scientifically demonstrated are limited,” researchers said.