A randomised controlled trial of a smoking cessation smartphone application

People using a smartphone application with an integrated mobile carbon monoxide checker were more likely to abstain from smoking in a randomised, sham-controlled, open-label study.

Dr Hiroki Tateno (Keio University School of Medicine, Japan) and colleagues sought to assess the long-term efficacy of CureApp —a smoking cessation app used as intervention in this study— in addition to pharmacotherapy at 31 smoking-cessation clinics in Japan from 2017 to 2018. “Smoking-cessation rates, especially the long-term continuous abstinence rates, have been unsatisfying, even when using pharmacotherapy,” Dr Tateno said during a presentation. “Cell phone apps have recently gathered attention in the medical field, but long-term efficacy of such apps has yet to be elucidated.” He reported the findings of their recently published study in the late-breaking trial session [1,2].

At the beginning of a 12-week standard smoking cessation programme that included counselling and pharmacotherapy with varenicline or a nicotine patch, 584 participants were randomly assigned to use the CureApp (n=285) or a control app (n=287). Patients had access to the apps for 24 weeks. Continuous abstinence rate, which was validated biochemically, from weeks 9 to 24 served as the primary outcome.

From weeks 9 to 24, the continuous abstinence rate in the CureApp group was superior to that observed in those in the control app group (63.9% vs 50.5%; OR 1.73; 95% CI 1.23-2.42; P=0.001). From weeks 9 to 52, the continuous abstinence rate was also significantly higher among the CureApp users vs the control app group (52.3% vs 41.5%; OR 1.55; 95% CI 1.11-2.15; P=0.01). The CureApp also proved superior to control in 7-day point prevalence abstinence at weeks 4, 8, 12, 24, and 52.

In terms of design, the CureApp offers animated video tutorials, interactive discussion with an automated guidance system, a digital diary, and measurements of daily exhaled carbon monoxide levels. Dr Tateno noted that the programmes were tailored to the initial input from participants’ profiles. A second component of the system allowed physicians to see participants’ progress on the web using a cloud-based system. The control app did not contain any of the potentially effective smoking cessation functions. Dr Tateno noted that the primary result from the trial showed that the difference in the continuous abstinence rate between the CureApp system and conventional treatment was 13.4% from weeks 9 to 24, and 12% for varenicline vs placebo in a previous report, indicating comparable efficacy of the investigated app to a pharmacological approach in smoking cessation.

1. Tateno H, et al. A7357, ATS 2019, 17-22 May, Dallas, Texas, USA.
2. [Nomura A, et al. JMIR Res Protoc. 2019 Feb 11;8(2):e12252.](https://www.ncbi.nlm.nih.gov/pubmed/30741641)

Posted on 23 July 201923 March 2021