Novel smartphone app shows promise for smoking cessation
DALLAS — People using a novel smartphone application with an integrated mobile carbon monoxide checker were more likely to abstain from smoking longer, according to research presented at the American Thoracic Society International Conference.
In a randomized, sham-controlled, open-label study, Tateno and colleagues sought to assess the long-term efficacy of CureApp — the novel smoking cessation app (CureApp Inc.) — in addition to pharmacotherapy at 31 smoking-cessation clinics in Japan from 2017 to 2018.
At the beginning of a 12-week standard smoking cessation program that included counseling and pharmacotherapy with varenicline (Chantix, Pfizer) or a nicotine patch, 584 participants were also randomly assigned to use the CureApp (n = 285) or a control app (n = 287). Patients had access to the apps for 24 weeks. Continuous abstinence rate, which was validated biochemically, from weeks 9 to 24 served as the primary outcome.
“Smoking-cessation rates, especially the long-term continuous abstinence rate has been unsatisfying, even when using pharmacotherapy,” Hiroki Tateno, MD, PhD, from the division of pulmonary medicine and the department of medicine at Keio University School of Medicine in Tokyo, said during a presentation. “Cell phone apps have recently gathered attention in the medical field, but long-term efficacy of such apps has yet to be elucidated.”
From weeks 9 to 24, the continuous abstinence rate in the smartphone app group was superior to that observed in those in the control-app group (63.9% vs. 50.5%; OR = 1.73; 95% CI, 1.23-2.42; P = .001). From weeks 9 to 52, the continuous abstinence rate was also significantly higher among the app users vs. the control-app group (52.3% vs. 41.5%; OR = 1.55; 95% CI, 1.11-2.15; P = .01).
The smartphone app also proved superior to control in 7-day point prevalence abstinence at weeks 4, 8, 12, 24 and 52.
In terms of design, the smartphone app offered animated video tutorials, interactive discussion with an automated guidance system, a digital diary and measurements of daily exhaled carbon monoxide levels. Tateno noted that the programs were tailored to the initial input from participants’ profiles. A second component of the system allowed physicians to see participants’ progress on the web using a cloud-based system. The control app did not contain any of the potentially effective smoking cessation functions.
“For nicotine addiction treatment, current medication is mainly effective for physical dependence, and there is a limited number of skillful physicians or counselors who can provide behavioral therapy for psychological dependence. We aim to provide solutions to the situation with the power of a smartphone application that can provide personalized continuous guidance and assistance to these patients,” Kohta Satake, MD, MPH, MBA, founder and CEO of CureApp Inc., told Healio Pulmonology.
Tateno noted that the primary result from the trial showed that the difference in the continuous abstinence rate between the CureApp system and conventional treatment was 13.4% from weeks 9 to 24, and 12% for varenicline vs. placebo in a previous report, indicating comparable efficacy of the solution to pharmacological approach.
In terms of next steps, Satake said the company plans on seeking regulatory approval and insurance reimbursement in Japan within a year and has a similar timeline for the U.S. market.
Although the device clinical trial was conducted in Japan, he added, the company aims to bring the app to the global market.
“Our device used for the trial was in fact tailored to Japanese patients, but we have been working on the U.S. patient-tailored app and are planning to test the efficacy soon,” Satake said. – by Melissa Foster
Tateno H. Abstract 7357. Presented at: American Thoracic Society International Conference; May 17-22, 2019; Dallas.
Disclosure s: Satake reports he is founder and CEO of CureApp Inc. Tateno reports he has received honoraria from CureApp Inc.