Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial

BackgroundThe overall prevalence of cigarette smokers in China is very high, and China’s total cigarette consumption makes up more than 40% of the world’s consumption. In view of the lack of smoking cessation services and social support in China and the effectiveness of mobil...

Full description

Bibliographic Details
Main Authors: Shanshan Chen, Jinsong Tang, Congyang Wu, Ge Zhang, Jing Zhang, Yanhui Liao
Format: Article
Language:English
Published: JMIR Publications 2024-03-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2024/1/e48050
_version_ 1797257903107735552
author Shanshan Chen
Jinsong Tang
Congyang Wu
Ge Zhang
Jing Zhang
Yanhui Liao
author_facet Shanshan Chen
Jinsong Tang
Congyang Wu
Ge Zhang
Jing Zhang
Yanhui Liao
author_sort Shanshan Chen
collection DOAJ
description BackgroundThe overall prevalence of cigarette smokers in China is very high, and China’s total cigarette consumption makes up more than 40% of the world’s consumption. In view of the lack of smoking cessation services and social support in China and the effectiveness of mobile phone apps for quitting smoking in other countries, we carried out a smartphone app–based smoking cessation trial in China. ObjectiveThis study aimed to evaluate the efficacy of a cognitive behavioral therapy (CBT)–based smoking cessation smartphone app among smokers seeking treatment in China. MethodsWe conducted a randomized controlled, web-based pilot clinical trial in China between February 23 and June 27, 2021. Eligible participants were randomly assigned to the smoking cessation app intervention group or the control group in a ratio of 1:1. The intervention group received the CBT smoking cessation intervention using a smartphone app, and the control group received a “thank you” message. The intervention was 4 weeks long, and the patients were followed up for 4 weeks. The primary outcome was self-reported continuous smoking abstinence at week 4 after the quit date. The secondary outcomes included self-reported 7-day point prevalence of smoking abstinence; reduction of the number of cigarettes smoked per day at weeks 1, 2, 3, and 4; and program acceptability. ResultsA total of 973 people were recruited to quit smoking, of whom 262 completed basic information, 56 were excluded, and 206 were randomized and included in the final analysis. There were 189 (91.7%) men and 17 (8.3%) women, with an average age of 34.46 (SD 7.53) years and an average daily smoking rate of 15.93 (SD 7.10) cigarettes/day. We found 30 (29.7%) of the 101 participants in the intervention group and 7 (6.7%) of the 105 participants in the control group reported continuous smoking cessation after the quit date at week 4 (odds ratio 5.92, 95% CI 3.78-9.26; P<.001). The 7-day point prevalence abstinence rate of the intervention group varied from 42.6% (43/101) to 46.5% (47/101) after 1, 2, 3, and 4 weeks, while the control group varied from 18.1% (19/105) to 26.7% (28/105). Compared to the control group, continued smokers consumed 1.5-3.0 fewer cigarettes per day in the intervention group. The overall program got positive user feedback with a high satisfaction rate (66/87, 76%) and an average Mobile Application Rating Scale user version score of 3.46. ConclusionsOur pilot study provided preliminary evidence that the CBT-based smoking cessation smartphone app led to improved smoking quit rates versus control in Chinese smokers. The study demonstrated the CBT-based smartphone app may be an effective and feasible digital treatment model to help smokers quit, which may improve smoking cessation service quality and accessibility in China. Trial RegistrationClinicalTrials.gov NCT04421170; https://clinicaltrials.gov/study/NCT04421170 International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2020-041985
first_indexed 2024-04-24T22:45:02Z
format Article
id doaj.art-b7439bae119f4d4c9d886f29b51a4af9
institution Directory Open Access Journal
issn 2561-326X
language English
last_indexed 2024-04-24T22:45:02Z
publishDate 2024-03-01
publisher JMIR Publications
record_format Article
series JMIR Formative Research
spelling doaj.art-b7439bae119f4d4c9d886f29b51a4af92024-03-18T13:00:56ZengJMIR PublicationsJMIR Formative Research2561-326X2024-03-018e4805010.2196/48050Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot TrialShanshan Chenhttps://orcid.org/0000-0003-2290-6914Jinsong Tanghttps://orcid.org/0000-0003-3796-1377Congyang Wuhttps://orcid.org/0009-0006-9424-6846Ge Zhanghttps://orcid.org/0009-0009-7455-0340Jing Zhanghttps://orcid.org/0009-0007-4959-1074Yanhui Liaohttps://orcid.org/0000-0003-4735-3252 BackgroundThe overall prevalence of cigarette smokers in China is very high, and China’s total cigarette consumption makes up more than 40% of the world’s consumption. In view of the lack of smoking cessation services and social support in China and the effectiveness of mobile phone apps for quitting smoking in other countries, we carried out a smartphone app–based smoking cessation trial in China. ObjectiveThis study aimed to evaluate the efficacy of a cognitive behavioral therapy (CBT)–based smoking cessation smartphone app among smokers seeking treatment in China. MethodsWe conducted a randomized controlled, web-based pilot clinical trial in China between February 23 and June 27, 2021. Eligible participants were randomly assigned to the smoking cessation app intervention group or the control group in a ratio of 1:1. The intervention group received the CBT smoking cessation intervention using a smartphone app, and the control group received a “thank you” message. The intervention was 4 weeks long, and the patients were followed up for 4 weeks. The primary outcome was self-reported continuous smoking abstinence at week 4 after the quit date. The secondary outcomes included self-reported 7-day point prevalence of smoking abstinence; reduction of the number of cigarettes smoked per day at weeks 1, 2, 3, and 4; and program acceptability. ResultsA total of 973 people were recruited to quit smoking, of whom 262 completed basic information, 56 were excluded, and 206 were randomized and included in the final analysis. There were 189 (91.7%) men and 17 (8.3%) women, with an average age of 34.46 (SD 7.53) years and an average daily smoking rate of 15.93 (SD 7.10) cigarettes/day. We found 30 (29.7%) of the 101 participants in the intervention group and 7 (6.7%) of the 105 participants in the control group reported continuous smoking cessation after the quit date at week 4 (odds ratio 5.92, 95% CI 3.78-9.26; P<.001). The 7-day point prevalence abstinence rate of the intervention group varied from 42.6% (43/101) to 46.5% (47/101) after 1, 2, 3, and 4 weeks, while the control group varied from 18.1% (19/105) to 26.7% (28/105). Compared to the control group, continued smokers consumed 1.5-3.0 fewer cigarettes per day in the intervention group. The overall program got positive user feedback with a high satisfaction rate (66/87, 76%) and an average Mobile Application Rating Scale user version score of 3.46. ConclusionsOur pilot study provided preliminary evidence that the CBT-based smoking cessation smartphone app led to improved smoking quit rates versus control in Chinese smokers. The study demonstrated the CBT-based smartphone app may be an effective and feasible digital treatment model to help smokers quit, which may improve smoking cessation service quality and accessibility in China. Trial RegistrationClinicalTrials.gov NCT04421170; https://clinicaltrials.gov/study/NCT04421170 International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2020-041985https://formative.jmir.org/2024/1/e48050
spellingShingle Shanshan Chen
Jinsong Tang
Congyang Wu
Ge Zhang
Jing Zhang
Yanhui Liao
Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
JMIR Formative Research
title Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
title_full Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
title_fullStr Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
title_full_unstemmed Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
title_short Preliminary Efficacy of a Cognitive Behavioral Therapy–Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial
title_sort preliminary efficacy of a cognitive behavioral therapy based smartphone app for smoking cessation in china randomized controlled pilot trial
url https://formative.jmir.org/2024/1/e48050
work_keys_str_mv AT shanshanchen preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial
AT jinsongtang preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial
AT congyangwu preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial
AT gezhang preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial
AT jingzhang preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial
AT yanhuiliao preliminaryefficacyofacognitivebehavioraltherapybasedsmartphoneappforsmokingcessationinchinarandomizedcontrolledpilottrial