JMIR Publications

ABSTRACT

Background:

Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. This randomized controlled trial (RCT) investigated the effectiveness of an app that encourages smokers to quit smoking with the help of a social network member (‘buddy’) in daily life.

Objective:

The objective of our study was to test the effectiveness of the SmokeFree buddy app compared to a control group with self-reported smoking abstinence and carbon monoxide (CO) verified smoking abstinence as primary outcomes and self-reports of smoked cigarettes per day (CPD) as secondary outcome.

Methods:

A total of 162 adult smokers participated in this single-blind, two-arm, parallel-group, intensive longitudinal RCT. Around a self-set quit date (7 days before the self-set quit date and 20 days after) and 6 months later, participants of the intervention (IG) and control group (CG) reported on daily smoking abstinence and CPD in end-of-day diaries. Daily smoking abstinence was verified via daily exhaled CO assessments. This assessment was administered via an app displaying results of exhaled CO, thus addressing self-monitoring in both groups. In addition, the IG used the SmokeFree buddy app, a multicomponent app that in particular facilitates social support from a buddy of choice.

Results:

Both groups significantly reduced their CPD from the baseline to the 6 months follow-up. Multilevel analyses revealed no significant intervention effect on self-reported and CO-verified daily smoking abstinence at the quit date, 3 weeks and 6 months later. However, in the IG CPD was decreased at the quit date and 3 weeks later compared to the CG. No group differences were found for continuous smoking abstinence 3 weeks and 6 months after the quit date. Overall, low SmokeFree buddy app engagement and low reported preceived usefulness were obsverved.

Conclusions:

The SmokeFree buddy app did not have beneficial effects on smoking over and above the self-monitoring control condition. Future studies should examine whether and what support processes can effectively be stimulated and how app use can be improved to better achieve this goal. Clinical Trial: International Standard Randomized Controlled Trial Number (ISRCTN) 11154315; https://www.isrctn.com/ISRCTN11154315.