The Effectiveness of Smartphone Applications to Aid Smoking Cessation: A Meta-Analysis

Abstract

Importance: Smartphone smoking cessation applications are extensively used by smokers to aid smoking cessation, are cost effective and widely available. Despite these benefits, their effectiveness remains inconclusive.Objective: To determine the effect of smoking cessation applications with or without standard smoking cessation interventions (usual care) on quit rates amongst adult smokers in comparison to control apps and/or usual care.Data sources: We searched Ovid Medline, CINAHL, Embase, AustHealth and the Cochrane Library on the 18th and 19th June 2018, updated on 22nd January 2019 supplemented by hand searching reference lists from relevant papers. Search terms for article retrieval included m-health, mhealth, smartphone, phone app, mobile app, mobile applications, quit smoking, smoking prevention, tobacco cessation, smoking cessation, smoking cessation programs, smoking, tobacco use cessation. The search was restricted to papers published in English, clinical trials, meta-analysis, randomised controlled trials and systematic review reviews.Study selection: We included randomised controlled trials and non-randomised controlled trials which enrolled currently smoking adults who wanted to quit smoking and reported smoking abstinence. We included studies that tested a dedicated smoking cessation application. Title and abstracts were screened by two authors independently using Covidence software. Disagreements were resolved by discussion with a third author.Data extraction and synthesis: Of 293 unique articles, 8 studies with a total of 3,543 participants met inclusion criteria. Risk ratio was calculated in RevMan using the default DerSimonian and Laird random effects model after Mantel-Haenszel fixed effects estimation.Main outcome measure: Smoking abstinence rates.Results: There was no statistically significant change in the rate of abstinence with smartphone smoking cessation applications, compared to usual care (RR 1.15, 95% CI 0.85 to 1.57). There was moderate heterogeneity (I2 57%) between studies.Conclusions and relevance: At present, there is insufficient evidence to routinely recommend smoking cessation applications for smoking cessation, however further research is warranted given the significant heterogeneity of the included studies which may have reduced the positive effects demonstrated in some studies.Funding: Self-funded by the authors.Declaration of Interest: As per the ICMJE Form for Disclosure of Potential Conflicts of Interest, the authors of this manuscript have no conflicts of interest.Ethical Approval: As this was a meta-analysis no ethical approval was required or was obtained.