The effectiveness of smartphone applications to aid smoking cessation: A meta-analysis

Abstract

IntroductionSmartphone smoking cessation applications (SCAs) are widely available and extensively used by smokers to aid smoking cessation. However, their efficacy is unproven. The aim of this meta-analysis was to determine the effect of SCAs with or without standard smoking cessation interventions (usual care) on quit rates amongst adult smokers in comparison to control apps and/or usual care. MethodsA comprehensive review of the literature conducted in January 2019 identified randomised controlled trials (RCTs) and non-RCTs published in English which investigated SCAs to aid smoking cessation in adults. Two authors screened 293 studies, of which 8 studies were included. The data for analysing smoking abstinence and risk of bias was extracted independently by two authors. Meta-analysis was conducted using the mixed-effects method in the RevMan software to calculate pooled risk ratios (RRs) with 95% confidence intervals. ResultsAcross 8 studies with 3,543 participants there was no statistically significant improvement in the rate of abstinence at 2 to 6 months compared to usual care (RR 1.15, 95% CI 0.85 to 1.57). There was moderate heterogeneity (with I2 of 57%) between the included studies. DiscussionAt present, there is insufficient evidence to routinely recommend SCAs for smoking cessation in usual care. However, further study is required to evaluate the effectiveness of SCAs as their low cost, wide availability and absence of side effects may make them useful adjuncts in some populations. Future RCTs could enrol participants using a more conventional approach applying methods published in trials evaluating medical adjuncts for smoking cessation. The studies included in this analysis demonstrate significant heterogeneity which may have reduced the capacity of the analysis to demonstrate significance.