A Community Pharmacist-led Smoking Cessation Intervention Using a Smartphone App (PharmQuit): A Randomized Controlled Trial

Abstract

Background: WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. PharmQuit, a smartphone app, was developed to support smoking cessation efforts by pharmacists taking into consideration the design of the app according to the needs of smokers. This study evaluated the effectiveness of smoking cessation services conducted by community pharmacists using PharmQuit compared with standard care.Methods: An open-label prospective, randomized, controlled trial was conducted. Stratified random sampling by sex, age, and nicotine addiction was used to allocate participants to either the intervention group or control group. Eligible participants were smokers 18 years old or older who smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies situated in three provinces in Thailand. In the intervention group, participants received smoking cessation services by community pharmacists using PharmQuit. The control group received standard care delivered by community pharmacists. Both groups were scheduled follow-ups at day 7, 14, 30, 60, 120, and 180. The primary outcomes were quit rate and number of cigarettes smoked per day. Secondary outcomes were exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. Analysis using the intent-to-treat principle was carried out. Results: A total of 156 smokers were randomly assigned to either the intervention (n=78) or control (n=78) group. Smoking cessation rates and the number of cigarettes smoked per day were significantly better over the follow-up visits in both groups (p<0.05). However, there were no statistically significant differences between the two groups. Adherence rate to the smoking cessation program was higher in the intervention group than the control group (74 days vs 60 days, p>0.05). Relapse rate was found to be lower in the intervention group as compared to the control group (28.6% vs 71.4%). Conclusions: The results showed obvious benefits of the community pharmacist’s contribution in helping smokers quit smoking. PharmQuit was not better than just pharmacist’s counselling but it might help to obtain better adherence to smoking cessation programs, and have less likelihood of relapse. Trial registration: Thai Clinical Trials Registry: TCTR20200925004. Registration date September 25, 2020 – Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841