The Effectiveness of Smartphone App–Based Interventions for Assisting Smoking Cessation: Systematic Review and Meta-analysis

Abstract

Background Smoking is a leading cause of premature death globally. Quitting smoking reduces the risk of all-cause mortality by 11%-34%. Smartphone app–based smoking cessation (SASC) interventions have been developed and are widely used. However, the evidence for the effectiveness of smartphone-based interventions for smoking cessation is currently equivocal. Objective The purpose of this study was to synthesize the evidence for the effectiveness of smartphone app–based interventions for smoking cessation. Methods We conducted a systematic review and meta-analysis of the effectiveness of smartphone interventions for smoking cessation based on the Cochrane methodology. An electronic literature search was performed using the Cochrane Library, Web of Science, PubMed, Embase, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases to identify published papers in English or Chinese (there was no time limit regarding the publication date). The outcome was the smoking abstinence rate, which was either a 7-day point prevalence abstinence rate or a continuous abstinence rate. Results A total of 9 randomized controlled trials involving 12,967 adults were selected for the final analysis. The selected studies from 6 countries (the United States, Spain, France, Switzerland, Canada, and Japan) were included in the meta-analysis between 2018 and 2022. Pooled effect sizes (across all follow-up time points) revealed no difference between the smartphone app group and the comparators (standard care, SMS text messaging intervention, web-based intervention, smoking cessation counseling, or apps as placebos without real function; odds ratio [OR] 1.25, 95% CI 0.99-1.56, P=.06, I2=73.6%). Based on the subanalyses, 6 trials comparing smartphone app interventions to comparator interventions reported no significant differences in effectiveness (OR 1.03, 95% CI 0.85-1.26, P=.74, I2=57.1%). However, the 3 trials that evaluated the combination of smartphone interventions combined with pharmacotherapy compared to pharmacotherapy alone found higher smoking abstinence rates in the combined intervention (OR 1.79, 95% CI 1.38-2.33, P=.74, I2=7.4%). All SASC interventions with higher levels of adherence were significantly more effective (OR 1.48, 95% CI 1.20-1.84, P<.001, I2=24.5%). Conclusions This systematic review and meta-analysis did not support the effectiveness of delivering smartphone-based interventions alone to achieve higher smoking abstinence rates. However, the efficacy of smartphone-based interventions increased when combined with pharmacotherapy-based smoking cessation approaches. Trial Registration PROSPERO CRD42021267615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=267615

Implementation of Community Health Worker Support for Tobacco Cessation: A Mixed-Methods Study

“…Future implementation may also explore CHW extension through telehealth [40], mobile apps [41], and group formats to promote scalability of the CHW TUD intervention.…”

“…Further research can explore different dosing schedules for initiation and maintenance of smoking cessation behaviors and cost-effectiveness of the CHW intervention. Future implementation may also explore CHW extension through telehealth [40], mobile apps [41], and group formats to promote scalability of the CHW TUD intervention.…”

“…Multiple quit attempts during the intervention may have led to more frequent CHW engagement, such that future testing of a bidirectional relationship between CHW engagement and outcomes is warranted. Future implementation study may also explore CHW extension through telehealth [38], mobile apps [39], and group formats to promote scalability of the CHW intervention.…”

Evaluation of effectiveness and acceptability of a psychological treatment for smoking cessation combined with a smartphone App: A pilot study

“…Regarding self-help Apps to quit smoking, the existing literature reveals significant heterogeneity in study design and mixed outcomes in terms of their effectiveness ( Barroso-Hurtado et al, 2021 ; Chu et al, 2021 ). In this line, a recent systematic review and meta-analyses examining the effectiveness of smartphone app–based interventions to quit smoking found no significant differences between the smartphone app group and the comparators (i.e., standard care, SMS text messaging intervention, web-based intervention) ( Guo et al, 2023 ). In contrast, Fang et al (2023) report that mobile Apps may have a significant short-term effect on abstinence (3-months follow-up) but not in the long-term (6-months follow-up).…”

“…Therefore, regardless of whether the Apps are self-help or combined with other treatments, the available systematic reviews of the literature highlight the existence of low certainty regarding the efficacy of smoking cessation Apps. The authors highlight the need for further research to determine the usefulness of smoking cessation Apps ( Chu et al, 2021 ; Guo et al, 2023 ; Whittaker et al, 2019 ).…”