Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 7, 2022
Date Accepted: Mar 10, 2023
The effectiveness of smartphone application-based interventions for assisting smoking cessation: A 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 interventions have been developed and are widely used.However, the evidence of the effectiveness of smartphone-based interventions for smoking cessation is currently controversial.
Objective:
The purpose of this study was to synthesize the evidence for the effectiveness of smartphone application-based interventions for smoking cessation.
Methods:
We conducted a 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 seven-day point prevalence abstinence rate or a continuous abstinence rate.
Results:
A total of nine randomized controlled trials with 12,967 adults were selected for the final analysis. The selected studies from six countries (United States, Spain, France, Switzerland, Canada, and Japan) were included in the meta-analysis between 2018-2022. Pooled effect sizes (across all follow-up time points) revealed no difference between the smartphone app group and the comparators (OR 1.25, 95% CI 0.99-1.56, P 0.06, I2 73.6%). Based on the sub-analyses, six trials of solely smartphone app-based interventions reported no significant differences in effectiveness (OR 1.03, 95% CI 0.85-1.26, P 0.74, I2 57.1%). However, the three trials that evaluated the combination of smartphone interventions and pharmacotherapy found higher smoking abstinence rates (OR 1.79, 95% CI 1.38-2.33, P 0.74, I2 7.4%). Interventions with higher levels of adherence were significantly more effective (OR 1.48, 95% CI 1.20-1.84, P < 0.01, I2 24.5%).
Conclusions:
The current 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 in when combined with pharmacotherapy smoking cessation approaches. Clinical Trial: PROSPERO CRD42021267615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221339
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