Review paper
CC-BY-NC 4.0

Effectiveness of Mobile Apps for Smoking Cessation: Α Review

Kabindra Regmi 1, 2  ,  
Norhayati Kassim 1, 3,  
University Brunei Darussalam, PAPRSB Institute of Health Science, Brunei Darussalam
Health Research and Innovation Center, Pokhara, Nepal
Health Promotion Center, Ministry of Health, Brunei Darussalam
Faculty of Public Health,Department of Primary Care and Public Health, Imperial, College London, UK
Tob. Prev. Cessation 2017;3(April):12
Publish date: 2017-04-12
Smartphone-based smoking cessation interventions are increasingly used around the world. However, the effects of smartphone applications on applicability and efficacy on cessation rate and prevention of relapses are not often evaluated. Therefore, this review aims to assess the evidence on effectiveness of smartphone applications as an intervention tool for smoking cessation support.

Material and Methods:
We conducted the search using Ovid Medline/PubMed, CENTRAL and Scopus databases dated (January 2007- June 2016). Inclusion criteria include randomized control trials or intervention studies with mobile applications that offer smoking cessation support. Two assessors independently extracted and evaluated the data from each included study

The review of eight selected studies illustrate the use of smartphone applications in increasing quit rates among smokers, however adherence to app features influences quit rates. Audiovisual features followed by a quit plan, tracking progress and sharing features are most accepted and utilised app features. However, inconsistency was observed in their association with abstinence or quit rate. App engagement features increase the statistical significance in the quit rate. Development of smartphone applications was supported by behaviour change theories in all studies nevertheless; heterogeneous forms of intervention were adopted within studies. Similarly, reduction in relapse attributed to enhanced discussion among quitters using social media applications was observed.

Quality evidence is warranted with large sample size to measure effect size of the intervention. Future research on effectiveness and efficacy of smartphone alone and comparisons with other mHealth interventions, such as text messaging would be useful.

Kabindra Regmi   
University Brunei Darussalam, PAPRSB Institute of Health Science, JlN Tungku link Road, BE 1410 Gadong, Brunei Darussalam
1. Whittaker, R., et al. Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews 2016 16, August, 2016; doi: 10.1002/14651858.CD006611.pub4.
2. Beaglehole, R., et al., Priority actions for the non-communicable disease crisis. The Lancet. 377(9775): p. 1438-1447. doi: 10.1016/S0140-6736(11)60393-0.
3. WHO. Tobacoo Fact sheet. [Internet] 2016 June 2016 [cited 2016 June 12]; Available from: (accessed 3 April 2017).
4. WHO, W.H.O., Global status report on noncommunicable diseases 2010, W.H. Organization, Editor. 2011. p. 176.
5. Stead, L.F., et al. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database of Systematic Reviews, 2016(3). doi: 10.1002/14651858.CD008286.pub3.
6. Doll, R., et al., Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ, 2004. 328(7455): p. 1519. doi: 10.1136/bmj.38142.554479.AE.
7. Whittaker, R., et al., Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev, 2016. 4: p. Cd006611. doi: 10.1002/14651858.CD006611.pub4.
8. Research2Guidance. mHealth App Developer Economics 2015:The current status and trends of the mHealth app market. [online research report] 2015 [cited 2016 13, July]; Available from: (accessed 3 April 2017).
9. WHO. Mobile health (mHealth) for tobacco control. Tobacco Free Initiative (TFI) [Internet] 2015 [cited 2016 June 28]; Available from: (accessed 3 April 2017).
10. Pujari, S., Tobacco control and mobile health (mHealth) - a new initiative, in The intersection of mobile health technology and tobacco control. 2011, WHO: (accessed 3 April 2017).
11. Smartphone Ownership and Internet Usage Continues to Climb in Emerging Economies. Febuary, 2016.
12. Union, I.T. ICT Facts & Figures: The World in 2015. [Internet] 2016 [cited 2016 June 14]; Available at: (accessed 3 April 2017).
13. Fanning, J., S.P. Mullen, and E. McAuley, Increasing Physical Activity With Mobile Devices: A Meta-Analysis. Journal of Medical Internet Research, 2012. 14(6): p. e161. doi: 10.2196/jmir.2171.
14. Casey, M., et al., Patients' experiences of using a smartphone application to increase physical activity: the SMART MOVE qualitative study in primary care. Br J Gen Pract, 2014. 64(625): p. e500-8. doi: 10.3399/bjgp14X680989.
15. Macias, C., et al., Using Smartphone Apps to Promote Psychiatric and Physical Well-Being. Psychiatr Q, 2015. 86(4): p. 505-19. doi: 10.1007/s11126-015-9337-7.
16. Smith, J.J., et al., Smart-phone obesity prevention trial for adolescent boys in low-income communities: the ATLAS RCT. Pediatrics, 2014. 134(3): p. e723-31. doi: 10.1542/peds.2014-1012.
17. Gilliland, J., et al., Using a Smartphone Application to Promote Healthy Dietary Behaviours and Local Food Consumption. Biomed Res Int, 2015. 2015: p. 841368. doi: 10.1155/2015/841368.
18. Robinson, E., et al., Development and feasibility testing of a smart phone based attentive eating intervention, in BMC Public Health. 2013. p. 639. doi: 10.1186/1471-2458-13-639.
19. Borrelli, B., et al., Prevalence and Frequency of mHealth and eHealth Use Among US and UK Smokers and Differences by Motivation to Quit. J Med Internet Res, 2015. 17(7): p. e164. doi: 10.2196/jmir.4420.
20. Twyman, L., et al., Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature. BMJ Open, 2014. 4(12). doi: 10.1136/bmjopen-2014-006414.
21. Payne, H.E., et al., Behavioral Functionality of Mobile Apps in Health Interventions: A Systematic Review of the Literature. JMIR mHealth uHealth, 2015. 3(1): p. e20. doi: 10.2196/mhealth.3335.
22. Free, C., et al., The effectiveness of M-health technologies for improving health and health services: a systematic review protocol. BMC Res Notes, 2010. 3: p. 250. doi: 10.1186/1756-0500-3-250.
23. Xu, W. and Y. Liu, mHealthApps: A Repository and Database of Mobile Health Apps. JMIR mHealth uHealth, 2015. 3(1): p. e28. doi: 10.2196/mhealth.4026.
24. Eapen, Z.J., E.D. Peterson, Can mobile health applications facilitate meaningful behavior change?: Time for answers. JAMA, 2015. 314(12): p. 1236-1237. doi: 10.1001/jama.2015.11067.
25. Ghorai, K., et al., mHealth for Smoking Cessation Programs: A Systematic Review. Journal of Personalized Medicine, 2014. 4(3): p. 412-423. doi: 10.3390/jpm4030412.
26. Higgins, J.P., et al., The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Bmj, 2011. 343: p. d5928. doi: 10.1136/bmj.d5928.
27. Leech, N.L., K.C. Barrett, and G.A. Morgan, IBM SPSS for intermediate statistics: Use and interpretation. 2014: Routledge.
28. Moher, D., et al., Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med, 2009. 6(7): p. e1000097. doi: 10.1371/journal.pmed.1000097.
29. Finkelstein, J. and M.E. Cha, Using a Mobile App to Promote Smoking Cessation in Hospitalized Patients. JMIR mHealth uHealth, 2016. 4(2): p. e59. doi: 10.2196/mhealth.5149.
30. Bricker, J.B., et al., Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug Alcohol Depend, 2014. 143: p. 87-94. doi: 10.1016/j.drugalcdep.2014.07.006.
31. Heffner, J.L., et al., Feature-level analysis of a novel smartphone application for smoking cessation. The American Journal of Drug and Alcohol Abuse, 2015. 41(1): p. 68-73. doi: 10.3109/00952990.2014.977486.
32. Zeng, E.Y., et al., Predictors of Utilization of a Novel Smoking Cessation Smartphone App. Telemedicine and e-Health, 2015. 21(12): p. 998-1004. doi 10.1089/tmj.2014.0232.
33. Zeng, E.Y., et al., Get with the program: Adherence to a smartphone app for smoking cessation. Addictive Behaviors, 2016. 63: p. 120-124. doi: 10.1016/j.addbeh.2016.07.007.
34. Ubhi, H.K., et al., A Mobile App to Aid Smoking Cessation: Preliminary Evaluation of SmokeFree28. Journal of Medical Internet Research, 2015. 17(1): p. e17. doi: 10.2196/jmir.3479.
35. Cheung, Y.T.D., et al., Using WhatsApp and Facebook Online Social Groups for Smoking Relapse Prevention for Recent Quitters: A Pilot Pragmatic Cluster Randomized Controlled Trial. J Med Internet Res, 2015. 17(10): p. e238. doi:10.2196/jmir.4829
36. Buller, D.B., et al., Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation. Telemed J E Health, 2014. 20(3): p. 206-14. doi: 10.1089/tmj.2013.0169.
37. Gruessner, V. The History of Mobile Health: From Cell Phones to Wearables. [Website] 2015 [cited 2016 11 August]; News]. Available at: (accessed 3 April 2017).
38. Ventola, C.L., Mobile Devices and Apps for Health Care Professionals: Uses and Benefits. Pharmacy and Therapeutics, 2014. 39(5): p. 356-364. PMCID: PMC4029126.
39. BinDhim, N.F., K. McGeechan, and L. Trevena, Assessing the effect of an interactive decision-aid smartphone smoking cessation application (app) on quit rates: a double-blind automated randomised control trial protocol. BMJ Open, 2014. 4(7): p. e005371. doi: 10.1136/bmjopen-2014-005371.
40. "Tobacco Quit and Save" app tracks daily savings. Home Healthc Nurse, 2014. 32(7): p. 391. doi: 10.1097/NHH.0000000000000100.
41. Witkiewitz, K., et al., Development and evaluation of a mobile intervention for heavy drinking and smoking among college students. Psychol Addict Behav, 2014. 28(3): p. 639-50. doi: 10.1037/a0034747.
42. Head, K.J., et al., Efficacy of text messaging-based interventions for health promotion: A meta-analysis. Social Science & Medicine, 2013. 97: p. 41-48. doi: 10.1016/j.socscimed.2013.08.003.
43. Abroms, L.C., et al., A content analysis of popular smartphone apps for smoking cessation. Am J Prev Med, 2013. 45(6): p. 732-6. doi: 10.1016/j.amepre.2013.07.008.
44. Choi, J., G.Y. Noh, and D.J. Park, Smoking cessation apps for smartphones: content analysis with the self-determination theory. J Med Internet Res, 2014. 16(2): p. e44. doi: 10.2196/jmir.3061.
45. Jacobs, M.A., et al., Facebook apps for smoking cessation: a review of content and adherence to evidence-based guidelines. J Med Internet Res, 2014. 16(9): p. e205.doi: 10.2196/jmir.3491.
46. Wang, Q., et al., Diet and Physical Activity Apps: Perceived Effectiveness by App Users. JMIR mHealth and uHealth, 2016. 4(2): p. e33. doi: 10.2196/mhealth.5114.
47. Hackshaw, A., Small studies: strengths and limitations. European Respiratory Journal, 2008. 32(5): p. 1141-1143. doi: 10.1183/09031936.00136408.
48. Lane, T.S., J. Armin, and J.S. Gordon, Online Recruitment Methods for Web-Based and Mobile Health Studies: A Review of the Literature. Journal of Medical Internet Research, 2015. 17(7): p. e183. doi: 10.2196/jmir.4359.
49. Watson, A.M., et al., Content Analysis of Anti-Tobacco Videogames: Characteristics, Content, and Qualities. Games for Health Journal, 2016. 5(3): p. 216-223. doi: 10.1089/g4h.2015.0096.
50. Hoeppner, B.B., et al., How Smart are Smartphone Apps for Smoking Cessation? A Content Analysis. Nicotine & Tobacco Research, 2016. 18(5): p. 1025-1031. doi: 10.1093/ntr/ntv117.
51. Agarwal, S., et al., Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist. BMJ, 2016. 352. doi: 10.1136/bmj.i1174.
52. Maher, C.A., et al., Are Health Behavior Change Interventions That Use Online Social Networks Effective? A Systematic Review. J Med Internet Res, 2014. 16(2): p. e40. doi: 10.2196/jmir.2952.
53. Hajek, P., et al., Relapse prevention interventions for smoking cessation. Cochrane Database of Systematic Reviews, 2013(8). doi: 10.1002/14651858.CD003999.pub4.
54. Elfeddali, I., et al., Preventing Smoking Relapse via Web-Based Computer-Tailored Feedback: A Randomized Controlled Trial. J Med Internet Res, 2012. 14(4): p. e109.
55. McClure, J.B., et al., Evaluating an Adaptive and Interactive mHealth Smoking Cessation and Medication Adherence Program: A Randomized Pilot Feasibility Study. JMIR Mhealth Uhealth, 2016. 4(3): p. e94. doi: 10.2196/mhealth.6002.
56. Pulverman, R. and P.M. Yellowlees, Smart Devices and a Future of Hybrid Tobacco Cessation Programs. Telemedicine and e-Health, 2014. 20(3): p. 241-245. doi: 10.1089/tmj.2013.0096.
57. Roth, W.R., et al., Practical considerations in the design and development of smartphone apps for behavior change. Journal of Contextual Behavioral Science, 2014. 3(4): p. 269-272. doi: 10.1016/j.jcbs.2014.08.006.
58. Valdivieso-Lopez, E., et al., Efficacy of a mobile application for smoking cessation in young people: study protocol for a clustered, randomized trial. BMC Public Health. 13: p. 704. doi: 10.1186/1471-2458-13-704.