The Stop-tabac smartphone application for smoking cessation: a randomized controlled trial.

Abstract

AimsTo test whether the Stop‐tabac smartphone application (app) increased smoking cessation rates.DesignA two‐arm, parallel‐group, individually randomized, double‐blind, controlled trial.Setting and ParticipantsA total of 5293 daily smokers (Stop‐tabac = 2639, control = 2654) enrolled on app stores and on the internet in 2019–20, who lived in France or Switzerland.Intervention and comparatorThe Stop‐tabac application includes immediate feedback during episodes of craving and withdrawal; individually tailored counseling messages with notifications sent during 6 months; a discussion forum; fact sheets; modules on nicotine replacement therapy and e‐cigarettes; and calculators of cigarettes not smoked, money saved and days of life gained since quitting. The control application included five brief pages and calculators as above.MeasurementsPrimary outcome: self‐reported smoking cessation after 6 months (no puff of tobacco in the past 4 weeks), with non‐responders counted as smokers. Secondary outcome: self‐reported use of nicotine medications.FindingsParticipants were aged 36 years on average; 66% were women who smoked 15 cigarettes/day, and 64% screened positive for depression. Stop‐tabac participants used the app over a longer period than control participants (23 versus 11 days, P < 0.001). Smoking cessation rates after 6 months were 9.9% in the Stop‐tabac group versus 10.3% in the control group (odds ratio = 0.96, 95% confidence interval = 0.80–1.45, P = 0.63). Rates of use of nicotine medications after entry in the study were 38 versus 30% after 6 months (χ2 = 8.3, P = 0.004) in the Stop‐tabac and control groups. After 6 months, 26% of participants in the Stop‐tabac group and 8% in the control group said that the app helped them ‘a lot’ or ‘enormously’ to quit smoking (χ2 = 113, P < 0.001).ConclusionsIn smokers enrolled on the app stores and the internet, allocation to the Stop‐tabac smoking cessation app did not increase smoking cessation rates, but increased rates of use of nicotine medications.