Smoking Cessation Apps: a Systematic Review of Format, Outcomes, and Features (Preprint)

Abstract

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).

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, using MEDLINE and PsycINFO databases to identify papers published up to 30th November 2020.

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.

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.

PROSPERO CRD42020154272; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020154272