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. 2017 Apr 12;3:12. doi: 10.18332/tpc/70088

Table 1.

Summary of included Studies.

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
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