Tobacco cessation apps
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Tobacco Cessation Apps: A Comprehensive Review
Introduction to Tobacco Cessation Apps
Tobacco cessation apps have emerged as a promising tool to help individuals quit smoking. These mobile health (mHealth) interventions offer the potential to provide accessible, cost-effective, and personalized support to a large number of users. This article synthesizes findings from multiple studies to evaluate the effectiveness, features, and adherence to evidence-based guidelines of these apps.
Effectiveness of Tobacco Cessation Apps
Randomized Controlled Trials (RCTs) and Pilot Studies
Several studies have evaluated the effectiveness of tobacco cessation apps through randomized controlled trials (RCTs) and pilot studies. For instance, a pilot RCT of the Smart-Treatment (Smart-T2) app, which uses ecological momentary assessments (EMAs) to tailor treatment messages, found that 22% of participants in the Smart-T2 group achieved 7-day point prevalence abstinence at 12 weeks post-quitting, compared to 15% in the control groups. Another pilot RCT focusing on individuals with serious mental illness (SMI) found that the Learn to Quit app led to greater reductions in cigarettes per day and higher usability scores compared to the QuitGuide app.
Systematic Reviews
Systematic reviews have also highlighted the potential of these apps. One review found that out of 18 studies, 11 were randomized controlled trials, with four reporting statistically significant results. The mean abstinence rate in single-arm trials was 33.9%. Another review noted that eight out of 24 studies reported significant differences in smoking cessation outcomes, with some favoring the use of apps.
Features of Effective Tobacco Cessation Apps
Self-Tracking and Quit Plans
Effective tobacco cessation apps often include features such as self-tracking and setting a quit plan. These features help users monitor their progress and stay motivated. For example, most general smoking cessation apps (GSC-Apps) include self-tracking and quit plans, while face-to-face support combined apps (FFSC-Apps) often incorporate self-tracking and carbon monoxide (CO) measures.
Just-in-Time Adaptive Interventions
Just-in-time adaptive interventions (JITAIs) are another promising feature. These interventions use real-time data to provide tailored support based on the user's current risk of smoking lapse. The Smart-T2 app is an example of a JITAI that has shown positive preliminary results in a pilot RCT.
Adherence to Evidence-Based Guidelines
Low Adherence Levels
Despite their potential, many tobacco cessation apps do not adhere to established clinical guidelines. A content analysis of popular apps found that they scored low on adherence to the U.S. Public Health Service's Clinical Practice Guidelines for Treating Tobacco Use and Dependence . Another study assessing apps against the National Institute of Care and Excellence (NICE) Smoking Cessation Guidelines found that a majority of apps had low adherence, with only 15% providing information about nicotine replacement therapy (NRT).
Need for Improvement
The low adherence levels indicate a need for improvement in the design and development of these apps. Integrating evidence-based practices and guidelines can enhance the effectiveness of tobacco cessation apps and provide better support to users .
Conclusion
Tobacco cessation apps offer a promising avenue for helping individuals quit smoking. While several studies have shown their potential effectiveness, there is a significant need for these apps to adhere more closely to evidence-based guidelines. Features such as self-tracking, quit plans, and just-in-time adaptive interventions can enhance user engagement and success rates. Future research should focus on improving the adherence of these apps to clinical guidelines to maximize their effectiveness and reach.
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