Two studies compared mobile applications with pharmacological or psychosocial treatments with the same treatments alone «Houston TK, Chen J, Amante DJ, ym. Effect of Techn...»3, «Carrasco-Hernandez L, Jódar-Sánchez F, Núñez-Benju...»4. In those studies, mobile applications increased successful abstinence at 6-12 months follow-up. Results may not apply to mobile applications other than those used in these two studies. Two review articles «Whittaker R, McRobbie H, Bullen C, ym. Mobile phon...»1, «Guo YQ, Chen Y, Dabbs AD, ym. The Effectiveness of...»2 compared mobile applications to other behavioral interventions or lower-intensity mobile applications and found no effect.
Description of the included studies
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| «Whittaker R, McRobbie H, Bullen C, ym. Mobile phon...»1 | SR/MA | Current smokers of any age. | Mobile application vs. lower intensity application or other low intensity support (including printed materials and encouragement to use support services) | Abstinence at six months or longer. Measured either by carbon monoxide test or by survey. | Low risk of bias in 3/5 studies, 1 study had incomplete outcome data, and 1 study unclear allocation concealment. Meta-analysis included heterogenous interventions in both intervention and comparison groups. |
| «Guo YQ, Chen Y, Dabbs AD, ym. The Effectiveness of...»2 | SR/MA | Current adult smokers | Mobile application vs. any other type of supportive smoking cessation. | 7-day point prevalence abstinence rate or a continuous abstinence rate | Some concerns. Loss to follow-up was often high. Meta-analysis included heterogenous interventions in both intervention and comparison groups. |
| «Houston TK, Chen J, Amante DJ, ym. Effect of Techn...»3 | RCT | Current adult smokers | Take a break mobile application + nicotine replacement therapy vs. nicotine replacement therapy alone | carbon monoxide level-verified smoking cessation at 6-month follow-up | Loss to follow-up ≈25%, otherwise low risk of bias |
| «Carrasco-Hernandez L, Jódar-Sánchez F, Núñez-Benju...»4 | RCT | Current adult smokers | Mobile application + psychopharmacological treatment vs. psychopharmacological treatment alone | carbon monoxide level-verified smoking cessation at 1-year follow-up | Low risk of bias |
RCT = randomized controlled trial; SR = systematic review; MA = meta-analysis
Additional comments for included studies
| Reference | Comments |
|---|---|
| «Whittaker R, McRobbie H, Bullen C, ym. Mobile phon...»1 | The risk of bias was mostly low. Heterogenous interventions in the meta-analysis limit the applicability of the results. Additionally, mobile applications were only compared to other behavioral interventions, which limits making conclusions of mobile applications compared to no behavioral intervention. |
| «Guo YQ, Chen Y, Dabbs AD, ym. The Effectiveness of...»2 | There were some concerns in the risk of bias assessment. Same limitations in applicability of results as in the Cochrane review. |
Results
Outcome 1 Abstinence at 6-12 months.
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| «Whittaker R, McRobbie H, Bullen C, ym. Mobile phon...»1 | 5 studies, 3079 patients (I 1535/C 1544) | 6 months | 111 | 119 | 1.00 (0.66–1.52) |
| «Guo YQ, Chen Y, Dabbs AD, ym. The Effectiveness of...»2 | 9 studies, 12,967 patients | 6-12 months | Not reported | Not reported | 1.25 (0.99–1.56) |
| «Houston TK, Chen J, Amante DJ, ym. Effect of Techn...»3 | I 160 / C 171 | 6 months | 28 | 17 | HR 1.92 (1.01–3.68) |
| «Carrasco-Hernandez L, Jódar-Sánchez F, Núñez-Benju...»4 | I 120 / C 120 | 12 months | 27.5% | 15.0% | OR 2.15 (1.13–4.08) |
| Level of evidence: low Assess the risk of bias and delete irrelevant sources of bias: The quality of evidence is downgraded due to indirectness. |
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I = intervention; C = comparison; CI = confidence interval