Quit Advisor Plus is an interactive decision-aid smartphone application (app) for smoking cessation with additional support features.
Quit Advisor Plus guides users to set a quit date in the next 7 days and choose a smoking cessation method (e.g., unassisted, nicotine replacement therapy (NRT), in-app self-help materials, Varenicline, Bupropion, aversion therapy, acupuncture, hypnosis, herbal therapy) through a structured process of weighing the benefits and harms of each method. The app also provides ongoing support for adherence to the chosen cessation method using daily motivational push notifications, a quitting diary, and a quitting benefits tracker (e.g., money saved). Based on a decision support framework, app content draws on theories and constructs from prospect theory, decision analysis, reasoned action, decisional conflict, social support, self-efficacy, and skills building.
Mobile application (app)
Smartphone Smoking Cessation Application (SSC App) trial: a multicountry double-blind automated randomised controlled trial of a smoking cessation decision-aid ‘app.’
BinDhim N, McGeechan K, Trevena L. BMJ Open. 2018. 8(1): e017105. doi: 10.1136/bmjopen-2017-017105
Summary: Researchers recruited adult smokers (n = 684) to participate in a double-blind randomized controlled trial examining the efficacy of an interactive smoking cessation decision-aid app compared with a static cessation information-only control app on continuous smoking abstinence. Recruitment occurred through Apple app store and in-app advertising in the United States, the UK, Singapore, and Australia. For this study, the Quit Advisor Plus app comprised two sub-apps: the intervention decision-aid app and an information-only control app. Quit Advisor Plus automatically randomized users who passed an eligibility screener (daily cigarette smokers aged 18 or older) to receive the intervention app (n = 342) or the control app (n = 342). Both the intervention app and the control app prompted participants to set a quit date in the next 7 days and report their chosen quit method. Participants completed questionnaires on decisional conflict and tobacco use and dependence at baseline and completed a measure of informed choice (e.g., knowledge and attitude towards smoking cessation) 10 days after their chosen quit date. Participants reported smoking behavior (continuous abstinence or current number of cigarettes smoked per day) in response to app push notifications at 10 days and 1, 3, and 6 months after their chosen quit date. Decision-aid participants were significantly more likely to be continuously abstinent at 10 days compared with control participants (32.2% vs. 20.8%), with the effect maintained at 1 month (28.5% vs. 16.9%), 3 months (23.8% vs. 10.2%), and 6 months (10.2% vs. 4.8%) post-quit date. Intervention participants were also significantly more likely than controls to have made an informed choice to quit (31.9% vs. 19.6%) and have lower decisional conflict (19.5% vs. 3.9%). There was no association between chosen cessation method and continuous abstinence and there were no significant differences in the effect of the decision-aid intervention between participants in different countries.
Take Away: An interactive smartphone decision-aid app significantly increased continuous smoking abstinence among adult smokers relative to an information-only control app, demonstrating both short-term and long-term impact. Science-based decision-aid apps with additional support features can be effective smoking cessation tools and warrant further research.