Impact of a Novel Smartphone App (CureApp Smoking Cessation) on Nicotine Dependence: Prospective Single-Arm Interventional Pilot Study.

Katsunori Masaki,Hiroki Tateno,Eriko Morino,Kazuma Sekine,Tomoko Betsuyaku,Shin Suzuki,Naofumi Kameyama,Kohta Satake,Riri Watanabe,Koichi Fukunaga,Tomohiro Ono,Akihiro Nomura

doi:10.2196/12694

Abstract

BackgroundMobile apps have been considered to provide active and continuous support for smoking cessation. However, it is yet to be known whether a smoking cessation smartphone app improves long-term abstinence rates in nicotine-dependent patients.ObjectiveThis study aimed to evaluate the long-term abstinence effect of a novel smartphone app, CureApp Smoking Cessation (CASC), in patients with nicotine dependence.MethodsIn this prospective, interventional, multicenter, single-arm study, we provided the CASC app to all the participants, who used it daily for 24 weeks. The CASC app includes features to maximize the therapeutic effect of pharmacological therapies and counseling at outpatient clinics for smoking cessation. The primary endpoint was a continuous abstinence rate (CAR) from weeks 9 to 24, whereas secondary endpoints were CARs from weeks 9 to 12 and 9 to 52.ResultsOf the 56 adult smokers recruited, 1 did not download the app; therefore, 55 participants constituted the full analysis sample. The CAR from weeks 9 to 24 was 64% (35/55, 95% CI 51%-76%), whereas the CARs from weeks 9 to 12 and 9 to 52 were 76% (42/55, 95% CI 65%-88%) and 58% (32/55, 95% CI 46%-71%), respectively. These CARs were better than the results of the national survey on outpatient clinics with regard to smoking cessation under the National Health Insurance Program and that of the varenicline phase 3 trial in Japan and the United States. There was only 1 participant who dropped out during the 12 weeks of the treatment period. This treatment decreased the scores related to withdrawal and craving symptoms.ConclusionsThe addition of CASC to usual smoking cessation therapies resulted in high CARs, high patient retention rates, and improvement of cessation-related symptoms. The smartphone app CASC is a feasible and useful tool to help long-term continuous abstinence that can be combined with a standard smoking cessation treatment program.

Highlights

Smoking Cessation TherapySmoking is a risk factor for cancer, respiratory disease, heart disease, and cerebral vascular disease [1]
The addition of CureApp Smoking Cessation (CASC) to usual smoking cessation therapies resulted in high continuous abstinence rate (CAR), high patient retention rates, and improvement of cessation-related symptoms
The smartphone app CASC is a feasible and useful tool to help long-term continuous abstinence that can be combined with a standard smoking cessation treatment program. (JMIR Mhealth Uhealth 2019;7(2):e12694) doi:10.2196/12694

Summary

Introduction

Background: Smoking Cessation TherapySmoking is a risk factor for cancer, respiratory disease, heart disease, and cerebral vascular disease [1]. In Japan, patients diagnosed with nicotine dependence and those who wish to quit smoking are eligible for treatment with varenicline or nicotine patches under the National Health Insurance Program (NHIP) [4]. Under the NHIP, physicians see their patients and provide pharmacotherapy and counseling 5 times during the 12-week treatment period according to the national guidelines (The Standard Procedure Manual for Smoking Cessation, 6th edition, 2014) [5]. Pharmacotherapy, which helps patients stop smoking, has been covered by NHIP since 2006, continuous abstinence rate (CAR) after 12 weeks has still remained low mainly because of the high dropout rate. Dropouts and the lack of visits mean that physicians cannot provide their patients sufficient support for smoking cessation. It is yet to be known whether a smoking cessation smartphone app improves long-term abstinence rates in nicotine-dependent patients

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