A Randomized Clinical Trial to Assess the Efficacy of a Psychological Treatment to Quit Smoking Assisted with an App: Study Protocol

Incorporating technology in smoking cessation interventions: In-person vs. Video-call formats

INTRODUCTION

The use of video calls to provide health-related interventions has grown significantly, showing positive results in a broad range of psychological interventions. Scarce research has examined video-call use in smoking cessation treatments. The purpose of this study was to compare two randomised controlled trials conducting a cognitive-behavioral intervention to quit smoking in-person versus using video calls.

MATERIAL AND METHODS

This study is a secondary analysis of two randomised controlled trial studies (RCTs) conducted using two delivery formats: in-person vs. video calls. The sample comprised 498 adults seeking smoking cessation treatment. We analysed smoking cessation, cigarette reduction, and treatment satisfaction outcomes according to delivery format.

RESULTS

No significant differences were found in sex, age, and baseline smoking-related variables. A significantly higher proportion of participants in the video-call format had university studies, were actively working, and had a history of depression compared to the in-person format. No significant differences were found in cessation, smoking reduction, and satisfaction with treatment. Predictive variables of 12-month abstinence were: baseline number of cigarettes smoked per day (OR = 0.93) in the case of the in-person format; and being a woman (OR = 0.53), cigarette dependence (OR = 0.46), and last year quit attempt (OR = 0.52) in the video-call format.

CONCLUSIONS

Both delivery formats showed similar abstinence rates at 12 months and satisfaction with the intervention. Therefore, in-person and video calls could be used to deliver smoking cessation treatments. Given that predictors of long-term abstinence differed across these delivery formats, further research is needed.

TRIALS REGISTRATION

ClinicalTrials.gov IDs: NCT02844595: NCT04765813.

The Efficacy of the SinHumo App Combined With a Psychological Treatment to Quit Smoking: A Randomized Clinical Trial

INTRODUCTION

This study assessed the efficacy of the SinHumo App combined with a cognitive-behavioral smoking cessation treatment on 12-month follow-up abstinence, compared with the same smoking cessation treatment and a control App.

AIMS AND METHODS

A sample of 288 treatment-seeking people who smoke were randomized: SinHumo App plus smoking cessation treatment (n = 140) and control App plus smoking cessation treatment (n = 148). The primary outcome was 7-day point prevalence abstinence (PPA) at the 12-month follow-up. Secondary outcomes were abstinence rates at the end of the intervention and 3- and 6-month follow-ups, cigarette per day (CPD) reduction over the 12-month follow-up, intervention engagement, and satisfaction.

RESULTS

Intention-to-treat analyses showed nonsignificant differences in self-reported 7-day PPA at the 12-month follow-up (37.1 and 42.6%, respectively; OR = 0.80). No significant differences were found in abstinence at the end of the treatment (68.6 vs. 62.8%) nor on 7-day PPA at 3- (35.7 vs. 45.9%) and 6-month (35.0 vs. 41.2%) follow-up. Complete case and multiple imputation analyses yielded similar results for abstinence outcomes. A significant reduction in CPD across the 12-month follow-up in the subsample of participants who smoked was observed, but nonsignificant differences between conditions were found. Higher engagement with the SinHumo App was a significant predictor of 12-month abstinence. Satisfaction with the intervention was high and similar in both groups.

CONCLUSIONS

High abstinence rates over the 12-month follow-up and satisfaction were found in both conditions. The inclusion of the SinHumo App did not improve abstinence rates in the intervention.

IMPLICATIONS

Scarce research has examined the long-term efficacy of smoking cessation treatments, including Apps, to support the quitting process. The present randomized controlled trial contributes to the existing literature about including information and communication technologies in behavior change interventions. The development of effective smoking cessation apps and information and communication technologies-based interventions is crucial for reducing the prevalence of smoking, as these interventions have the potential to reach a large number of people who smoke and reduce access-related barriers to treatment.

Smoking and Its Impact on Orthodontic Treatment/Management Modalities: A Systematic Review and Meta-Analysis

Background

We aimed to review studies that evaluated the effect of cigarette smoking on orthodontic treatment methods and determine whether the smoke affected appliances in a way that could impair the effectiveness of the overall treatment strategy.

Methods

PubMed, Google Scholar, Cochrane Library, and Web of Science were scoured using pertinent keywords, reference searches, and citation searches in accordance with the PRISMA protocol regarding articles published from 2008 till 2022.

Results

Ultimately, 7 papers were chosen for further analysis at the end of the selection protocol. Overall pooled odds ratio (OR) for the impact of cigarette smoking on orthodontic treatment was 0.25 (95% CI: 0.15, 0.43), with high statistical significance (P<0.00001) but also high heterogeneity (I2 = 81%). The relative risk (RR) was 0.50 (95% CI: 0.38, 0.66), indicating a 50% greater risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I2 = 79%), and the risk difference (RD), which was -0.33 (95% CI: -0.45, -0.21), suggesting a 33% higher risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I2 = 81%). The high heterogeneity in all measures indicates significant variability in the results across the included studies.

Conclusion

All the 7 studies selected for our systematic review exhibited significant detrimental associations between smoking and orthodontic appliances and other modalities that were exposed to cigarette smoke. However, more studies need to be done in this regard, since the literature currently available on this relationship is quite poor and lacking in concrete evidence.

Use of the Therapy App Prescinde for Increasing Adherence to Smoking Cessation Treatment

Tobacco use poses major health risks and is a major contributor to causes of death worldwide. Mobile phone-based cessation apps for this substance are gaining popularity, often used as a component of traditional interventions. This study aimed to analyze adherence to an intervention using a mobile phone application (App-therapy Prescinde (v1)) as a function of sociodemographic variables (age, gender, educational level, and profession) as well as the primary activities supported by the app (reducing tobacco or cannabis use and increasing physical exercise). The participants were recruited through the web pages of the Occupational Risk Prevention Service and the Psychology Clinic of the University of Granada during the COVID-19 confinement period. The application's contents include three components (self-report, motivational phrases, and goal setting). Our findings indicate that being male, being aged between 26 and 62, having a high school education, and being unemployed increase the likelihood of adherence to the Prescinde therapy app three months after usage. Our findings highlight the importance of developing new therapeutic approaches and conducting in-depth studies on the factors associated with adherence to tobacco cessation and cannabis cessation treatments via mobile phone applications.