Table 1.
Author/Country | Finkelstein& Cha, 2016 USA | Buller DB, et al. 2014, Australia | Bricker JB, et al. 2014, USA | Heffner LJ, et al. 2014, USA | Ubhi KH, et al. 2015, England | Zeng et al. 2015, USA | Zeng et al. 2016, USA | Cheung et al 2015 Hong Kong |
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Title | Using Mobile app to promote smoking cessation in Hospitalized patient. | Randomized trial of smartphone mobile application compared to text messaging to support smoking cessation | Randomized controlled pilot trial of smartphone app for smoking cessation using acceptance and commitment therapy | Feature level analysis of novel smartphone application for smoking cessation | A Mobile App to Aid Smoking Cessation: Preliminary Evaluation of SmokeFree28 | Predictors of utilization of a Novel Smoking cessation smartphone App. | Get with the program: Adherence to a smartphone app for smoking cessation | Using WhatsApp and Facebook Online Social Groups for Smoking Relapse Prevention for Recent Quitters: A Pilot Pragmatic Cluster Randomized Controlled Trial |
Design features | Prospective Intervention design N=55 | RCT (Pre-test, post-test Two group design) N=102 | Pilot RCT, stratified randomization N=196 | Single arm Post hoc analysis of RCT N=96 | Interventional Study N=1135 | Pilot RCT, Two arm N=98 | Single arm pilot study (Quasi experiment) N=84 | Pilot single-blinded, parallel, 3-arm pilot, cluster randomized controlled trial N=136 |
Description of the Mobile application | Name: Computer assisted Education system (CO-ED) Theory: Adult learning and instructional technology, Information processing theory, Constructive theory, Cognitive flexibility theory, Submission theory, Drive Reduction theory, Cognitive load theory. Features: Knowledge repository containing educational content and user interface supporting content delivered via multiple platform; tablet, smartphone, gaming, touch screens Available platform: NA |
Name: Real E Quit Mobile application (REQ-Mobile) Theory: Unclear Features: Receive test message, Support document (benefit of quitting, strategies for stopping NRT, coping and withdrawal), quit plan supported by automated messages. |
Name: Smart Quit Theory: Action and Commitment Theory (ACT) Features: 1) Staying motivated focus on ACT values via testimonials of formers smokers describing how quitting smoking has help them do things that deeply matter them e.g. time spent with family, Pictorial message with reasons of quit2) Personalized Quit plan 3) audio and text base skill presented for coping with cravings to smoke, 4) Audio and text-smoking lapsed and self-judgement tool 5) Tracking of actions. Name: Quit Guide app: from National Cancer Institute Theory : Not clear Based on Clinical practice guideline Features: Features and content drawn from smokefree.gov website.1)Reason based motivation to quit 2) Personalized quit plan 3) Social support 4) Information on FDA approved medication 5)Teach skills to cope carving, give technique, share success |
Name: Smart Quit Theory : ACT and Cognitive Behavioural Therapy (CBT) Features: ACT specific exercise are grouped for motivation text and video, skills to accept urges to smoke, and coping skills. Non ACT/CBT features: self-monitoring with feedback, (tracking and viewing progress), positive reinforcement, creating a quit plan and sharing progress via email, text and social media. Name: Quit Guide app: from National Cancer Institute Theory : NA Features: NA |
Name: SmokeFree28 Theory: Behaviour change theories PRIME theory (Plans, Responses, Impulses, Motives, and Evaluations). Features: Quit plan and preparatory behavioural modification to quit before Specific daily message and planning activities for 28 days. |
Name: Smart Quit Theory: Action and Commitment Theory Features: Exercise designed to increase willingness to experience trigger situation without smoking, Increase recovery skills for smoking lapses and develop self-compassion |
Name: ACT-based cessation App Theory: ACT Evidence based: YES65 Features: 1) creating a quit plan 2) completing eight daily ACT modules 3) tracking letting ten urges pass visiting t 4) Anytime Coaching section at least once |
Name: Whats app and Online Facebook Theory: Unclear Feature: Social group function of the application Reminders from the moderators texts, pictures, and videos, were based on the “Treatments for the Recent Quitter” of the US Clinical Practice Guidelines on Treating Tobacco Use and Dependence [2], including (1) encourage to maintain abstinence, (2) remind about the importance of remaining abstinence, (3) prevent smoking triggers, (4) remind about the withdrawal symptoms and lapse, (5) advise about stress and mood management, and (6) advise about weight control |
Participants | Two US Hospital smokers Age: Sampling: consecutive selection, sample size: 55 Recruitment: Hospital admission | US Adult smokers (18-30) Sampling : Online recruitment, Probability sampling sample 102 | US adults 18+or older smokers smoking at least 5 cigarettes daily for at least 12 month Sampling : probability 196 Recruitment: Online (Facebook, website, search engine ) Offline: TV advertisement | Exploratory study of randomized app users | Automated data collected on each time potential user open the app. Participant set the quit date and each day of abstinence was rewarded by the app |
Two arm randomized | Single arm Pilot randomization Intervention study | WhatsApp group chat Facebook chat as intervention platform 3 reminders per week Cluster Randomization using random number Masking of Clients And recruiters were weekly notified |
Comparison | Post Intervention comparison | Mobile application Vs Text messaging | Smart Quit app based on Acceptance and commitment therapy VS Quit guide app | Smart Quit Vs Quit Guide App | None | None | None | WhatsApp Vs Facebook group online discussion and booklet Control : No-group discussion |
Outcome measures | Difference in knowledge test score pre and post App use, Process of smoking cessation (Stage of TTM) Smoking self-Qualitative verbatim transcription | Questionnaires: Baseline,6 weeks post-test, smokers reported smoking status Readiness to quit Point prevalence abstinence of smoking |
Thirty day point prevalence abstinence | App utilization Smoking cessation point prevalence rates Questionnaire | 28 days abstinence | User characteristics (by Education, Heavier smoking, No of close friend who smoke, Anxiety, Depression) and utilization of app | Smoking cessation (two-month post-randomization 7-day point prevalence abstinence via self-report,) Adherence rate | Relapse prevention rate in Facebook, WhatsApp and Control group |
Duration of intervention | 45 minutes for a session, Duration of intervention not reported. | 12 weeks | 8 weeks | 60 day post randomization | 28 days | 8 weeks | 2 month | 6 month |
Key findings | Knowledge gain was the main predictor of more favourable attitudes towards mobile app (OR 4.8, CI 1.1, 20.0) | 30 day point prevalence abstinence r=0.32, p=0.14 and continuous abstinence r=0.31, p=0.09. | Smart app quit rate with ACT was 13% Smart app with quick guide was 8% (OR 2.7;95% C.I, 0.8-20.7) | Viewing and staying motivated video (OR 4.1 95% CI (0.9-17.6), Urge exercise “Leaves on stream” video (OR 4.1 95% CI (0.9-17.6 ), predicted smoking abstinence n=15 users) |
The self-reported smoking cessation rate for 28 days or longer was 18.9% (95% CI 16.7-21.1). Recorded abstinence was significantly associated with older age, non-manual occupational group, and use of a stop-smoking medicine but not with daily cigarette consumption | Heavier smoking, depression and lower education were predictive of app utilization Heavier smoking (RR 0.95; p=0.003) Lower Education (RR:0.492; p=0.021 ) Depression (RR: 0.958; p=0.017) |
Fully adherent users (24%) were over four times more likely to quit smoking (OR = 4.45; 95% CI = 1.13, 17.45; p = 0.032). | Fewer participants in the WhatsApp group reported relapse than the control group at 2-month (OR 0.27, 95% CI 0.10-0.71) and 6-month; OR 0.43, 95% CI 0.19-0.99) follow-ups. The Facebook group had an insignificantly lower relapse rate than the control group at 2-month (OR 0.58, 95% CI 0.24-1.37) and 6-month OR 0.70, 95% CI 0.31-1.61) follow-ups. |
RCT- Randomized control trials, ACT- Action and Commitment Theory, OR- odds ratio, RR- Relative Risk, CI- Confidence Interval NA- Not Available/Unclear