Randomized factorial experiment of components of the SmokeFree Baby smartphone application to aid smoking cessation in pregnancy

Tombor, Ildikó; Beard, Emma; Brown, Jamie; Shahab, Lion; Michie, Susan; West, Robert

doi:10.1093/tbm/iby073

Cited by 32 publications

(39 citation statements)

References 35 publications

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“…One RCT has found that an app acting as a decision aid for smokers interested in stopping smoking resulted in higher 6-month abstinence rates than an information-only app 8 . Another RCT examined the effectiveness of a set of app components as an aid to cessation in pregnant smokers; engagement with the app was low and no specific components were found to increase short-term self-reported abstinence rates 9 . To date, no RCTs have been published comparing apps designed to provide ongoing support for quit attempts with unaided quitting, or more intensive versus less intensive versions of an app.…”

Section: Introductionmentioning

confidence: 99%

Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: an exploratory randomised controlled trial

et al. 2019

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Background: Smartphone applications (apps) are popular aids for smoking cessation. Smoke Free is an app that delivers behaviour change techniques used in effective face-to-face behavioural support programmes. The aim of this study was to assess whether the full version of Smoke Free is more effective than the reduced version. Methods: This was a two-arm exploratory randomised controlled trial. Smokers who downloaded Smoke Free were randomly offered the full or reduced version; 28,112 smokers aged 18+ years who set a quit date were included. The full version provided updates on benefits of abstinence, progress (days smoke free), virtual ‘badges’ and daily ‘missions’ with push notifications aimed at preventing and managing cravings. The reduced version did not include the missions. At baseline the app recorded users’: device type (iPhone or Android), age, sex, daily cigarette consumption, time to first cigarette of the day, and educational level. The primary outcome was self-reported complete abstinence from the quit date in a 3-month follow-up questionnaire delivered via the app. Analyses conducted included logistic regressions of outcome on to app version (full versus reduced) with adjustment for baseline variables using both intention-to-treat/missing-equals smoking (MES) and follow-up-only (FUO) analyses. Results: The 3-month follow-up rate was 8.5% (n=1,213) for the intervention and 6.5% (n=901) for the control. A total of 234 participants reported not smoking in the intervention versus 124 in the control, representing 1.6% versus 0.9% in the MES analysis and 19.3% versus 13.8% in the FUO analysis. Adjusted odds ratios were 1.90, 95%CI=1.53-2.37 (p<0.001) and 1.50, 95%CI=1.18-1.91 (p<0.001) in the MES and FUO analyses respectively. Conclusions: Despite very low follow-up rates using in-app follow up, both intention-to-treat/missing equals smoking and follow-up only analyses showed the full version of the Smoke Free app to result in higher self-reported 3-month continuous smoking abstinence rates than the reduced version.

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Section: Introductionmentioning

confidence: 99%

Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: an exploratory randomised controlled trial

et al. 2019

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“…Some studies designed specifically with apps for pregnant smokers [23,24] have reported promising results with digital smoking cessation interventions, but despite their systematic development and usability testing, engagement was low and did not appear to increase smoking abstinence during pregnancy [25]. A recent study seems to show that choice of an app for smoking cessation can be influenced by its immediate appearance and “social successes” [26].…”

Section: Discussionmentioning

confidence: 99%

Exploring Efficacy of a Serious Game (Tobbstop) for Smoking Cessation During Pregnancy: Randomized Controlled Trial

Marín-Gomez¹,

Marchán²,

Mayos-Fernandez³

et al. 2019

JMIR Serious Games

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Background Tobacco use during pregnancy entails a serious risk to the mother and harmful effects on the development of the child. Europe has the highest tobacco smoking prevalence (19.3%) compared with the 6.8% global mean. Between 20% to 30% of pregnant women used tobacco during pregnancy worldwide. These data emphasize the urgent need for community education and implementation of prevention strategies focused on the risks associated with tobacco use during pregnancy. Objective The aim of this study was to investigate the efficacy of an intervention that incorporates a serious game (Tobbstop) to help pregnant smokers quit smoking. Methods A two-arm randomized controlled trial enrolled 42 women who visited 2 primary care centers in Catalonia, Spain, between March 2015 and November 2016. All participants were pregnant smokers, above 18 years old, attending consultation with a midwife during the first trimester of pregnancy, and had expressed their desire to stop smoking. Participants were randomized to the intervention (n=21) or control group (n=21). The intervention group was instructed to install the game on their mobile phone or tablet and use it for 3 months. Until delivery, all the participants were assessed on their stage of smoking cessation during their follow-up midwife consultations. The primary outcome was continuous tobacco abstinence until delivery confirmed by the amount of carbon monoxide at each visit, measured with a carboxymeter. Results Continuous abstinence until delivery outcome was 57% (12/21) in the intervention group versus 14% (3/21) in the control group (hazard ratio=4.31; 95% CI 1.87-9.97; P =.001). The mean of total days without smoking until delivery was higher in the intervention group (mean 139.75, SD 21.76) compared with the control group (mean 33.28, SD 13.27; P <.001). In addition, a Kapplan-Meier survival analysis showed that intervention group has a higher abstinence rate compared with the control group (log-rank test, χ 2 1 =13.91; P <.001). Conclusions Serious game use is associated with an increased likelihood to maintain abstinence during the intervention period if compared with those not using the game. Pregnancy is an ideal opportunity to intervene and control tobacco use among future mothers. On the other hand, serious games are an emerging technology, growing in importance, which are shown to be a good tool to help quitting smoking during pregnancy and also to maintain this abstinent behavior. However, because of the study design limitations, these outcomes should be interpreted with caution. More research, using larger samples and longer follow-up periods, is needed to replicate the findings of this study. Trial Registration ClinicalTrials.gov NCT01734421; https://clinicaltria...

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“…Similarly to internet-based interventions, mobile apps are also suitable for smoking cessation during pregnancy; they are flexible, remote and non-judgmental [4]. However, although such intervention are seem attractive and offer wide reach, at least in theory, there exists only very limited research about their effectiveness for real behaviour [3,4,24].…”

Section: Mobile and Internet Opportunities For Effective Interventionsmentioning

confidence: 99%

“…Importantly, in most countries there is limited availability of evidence-based cessation support, and this includes services dedicated to women who are pregnant and smoking. Digital behaviour change intervention (DBCI) such as websites or smartphone apps could provide behavioural support to pregnant smokers wanting to quit, especially if they cannot or do not want to access traditional face-to-face support, although research on the topic remains limited [2][3][4][5]. To date, no smartphone-based intervention supporting quitting smoking has been developed to support women in Poland to quit.…”

Section: Introductionmentioning

confidence: 99%

Give it up! – a new mobile app and campaign supporting women to quit smoking in Poland – project rationale and app description

Stelmach¹,

Janik-Koncewicz²,

Herbeć³

et al. 2018

jhi

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Smoking during pregnancy is one of the most dangerous health behaviours. Historically, smoking during pregnancy in European countries was common. At the end of 20 th century in many European countries, including Poland, around 20-40% of children were born after 9 month exposure to toxic factors of tobacco smoke. In the last decades prevalence of smoking among women has declined substantially. In 2015, the overall smoking prevalence among women in the WHO European region was 19.1%, while among pregnant women it was 5.9%. Female smoking rates in Asia contrast sharply with Europe. In the WHO Western Pacific region only 1.1% of women, and only 0.9% of pregnant women, are smokers. In 2017 in Poland around 23 thousand children were born to mothers smoking during pregnancy. Therefore, the Health Promotion Foundation, in collaboration with MSD Foundation for Women's Health, undertook the initiative to help Polish women quit smoking using new technologies. A mobile app called "Give it up!" has been created. This Polish-language app is designed for young women, especially those who are expecting a baby or thinking about motherhood. This publication presents the programme rationale and app description.

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Randomized factorial experiment of components of the SmokeFree Baby smartphone application to aid smoking cessation in pregnancy

Cited by 32 publications

References 35 publications

Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: an exploratory randomised controlled trial

Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: an exploratory randomised controlled trial

Exploring Efficacy of a Serious Game (Tobbstop) for Smoking Cessation During Pregnancy: Randomized Controlled Trial

Give it up! – a new mobile app and campaign supporting women to quit smoking in Poland – project rationale and app description

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