Smartphone apps may be almost 3 times as effective as no or minimal support in helping people quit smoking long-term, according to a pooled data analysis published in BMJ Evidence Based Medicine.
Researchers say the findings highlight the potential for high-quality smoking cessation apps to play a greater role alongside established quit strategies.
The study
The analysis examined whether smartphone apps – used alone or combined with traditional approaches such as nicotine replacement therapy (NRT) and counselling – help people achieve continuous abstinence from smoking for at least 6 months.
Data from 31 randomised controlled trials involving 12,802 participants were included.
Low-certainty evidence from 4 studies (1402 participants) suggests that apps used on their own may nearly triple the rate of 6-month continuous abstinence compared with no or minimal support, increasing the number of quitters by approximately 40 per 1000 people.
When combined with traditional interventions, apps were associated with almost double the 6-month abstinence rate compared with traditional approaches alone.
Apps used alongside pharmacotherapy also improved long-term quitting outcomes, increasing abstinence by 77% compared with pharmacotherapy alone.
The strongest results were seen with apps based on psychological behavioural theories such as cognitive behavioural therapy (CBT), acceptance and commitment therapy, and mindfulness.
High-certainty evidence showed these apps significantly improved abstinence at 3 months (69%) and 6 months (36%) compared with apps based on traditional behavioural models.
‘Real-time behavioural support’
“Smartphone apps can deliver intensive, interactive and real-time behavioural support, exceeding the effect of brief advice,” say the researchers.
“A clear dose–response relationship exists between counselling intensity and quit success, and apps help meet this need while bypassing barriers such as limited clinic capacity, staff time, and declining use of telephone quitlines.
“Consequently, smartphone apps represent a scalable alternative or adjunct to traditional cessation services, particularly in resource-limited settings,” they say.
Promising, but more research needed
However, according to the researchers, the certainty of the evidence remains low due to limited sample sizes and methodological limitations, including design variations in the apps and their use.
The researchers caution that the findings “should be viewed as generating a hypothesis for future research rather than as a definitive conclusion”.
“Should future evidence confirm lasting benefits and pinpoint key features, rigorously validated apps could become a cornerstone of global tobacco control efforts,” the researchers conclude.
