The Stop‐tabac smartphone application for smoking cessation: a randomized controlled trial

AIMS: To test whether the Stop‐tabac smartphone application (app) increased smoking cessation rates. DESIGN: A two‐arm, parallel‐group, individually randomized, double‐blind, controlled trial. SETTING AND PARTICIPANTS: A total of 5293 daily smokers (Stop‐tabac = 2639, control = 2654) enrolled on app stores and on the internet in 2019–20, who lived in France or Switzerland. INTERVENTION AND COMPARATOR: The Stop‐tabac application includes immediate feedback during episodes of craving and withdrawal; individually tailored counseling messages with notifications sent during 6 months; a discussion forum; fact sheets; modules on nicotine replacement therapy and e‐cigarettes; and calculators of cigarettes not smoked, money saved and days of life gained since quitting. The control application included five brief pages and calculators as above. MEASUREMENTS: Primary outcome: self‐reported smoking cessation after 6 months (no puff of tobacco in the past 4 weeks), with non‐responders counted as smokers. Secondary outcome: self‐reported use of nicotine medications. FINDINGS: Participants were aged 36 years on average; 66% were women who smoked 15 cigarettes/day, and 64% screened positive for depression. Stop‐tabac participants used the app over a longer period than control participants (23 versus 11 days, P < 0.001). Smoking cessation rates after 6 months were 9.9% in the Stop‐tabac group versus 10.3% in the control group (odds ratio = 0.96, 95% confidence interval = 0.80–1.45, P = 0.63). Rates of use of nicotine medications after entry in the study were 38 versus 30% after 6 months (χ(2) = 8.3, P = 0.004) in the Stop‐tabac and control groups. After 6 months, 26% of participants in the Stop‐tabac group and 8% in the control group said that the app helped them ‘a lot’ or ‘enormously’ to quit smoking (χ(2) = 113, P < 0.001). CONCLUSIONS: In smokers enrolled on the app stores and the internet, allocation to the Stop‐tabac smoking cessation app did not increase smoking cessation rates, but increased rates of use of nicotine medications.