Overview
- The systematic review pooled 31 randomized trials with about 12,800 participants and found apps outperformed minimal or no support for six-month continuous abstinence.
- Adding an app to standard cessation care was linked to higher quit rates, including alongside pharmacotherapy, though estimates showed high heterogeneity and low-certainty evidence.
- Compared with guideline-based apps lacking explicit theory, apps built on psychological–behavioural frameworks showed stronger short-term abstinence outcomes, with high-certainty evidence for seven-day abstinence at six months.
- Quantitatively, app-only support was associated with a relative risk of 2.85 for six-month continuous abstinence versus minimal support, while pairing apps with medication showed a relative risk of 1.77 versus medication alone.
- Authors highlight smartphone tools as scalable, low-cost options for resource-limited settings and call for larger, longer trials with biochemical validation to confirm durability and identify essential features, including engagement elements such as gamification.