Effectiveness of a Digital Peer-Supported App Intervention in Promoting Smoking Cessations: Nonrandomized Controlled Trial

Abstract

Background: Smoking cessation has become a global priority, with peer support interventions shown to improve abstinence rates. However, no studies have examined the effectiveness of a group-based digital peer-supported app combined with nicotine gum for smoking cessation among working populations. Objective: This study aimed to assess whether adding a digital peer-supported app to standard nicotine gums improves 12-week smoking abstinence rates among current working smokers in employment-based settings. Methods: A nonrandomized comparison trial was conducted with current working smokers in Japan. Eligible participants smoked at least 1 cigarette per day, owned a smartphone (iOS or Android), and were enrolled in their company’s health insurance program. Participants were self-selected into one of the two intervention groups (digital peer-supported app + nicotine gums) or a control group (nicotine gums only). The digital peer-supported app creates a group chat for up to 5 people aimed at smoking cessation, where participants can anonymously post counts, photos, and comments daily. Logistic regression analyses adjusted for demographic and smoking-related variables were used to estimate the odds ratios for smoking cessation. Engagement with the app (usage days and posting frequency) was analyzed within the intervention groups. Results: A total of 451 participants were included in the per-protocol analysis (260 in the intervention groups and 191 in the control group). The 12-week abstinence rate was significantly higher in the digital peer-supported app + nicotine gum group compared to the gum-only group (59.2% [154/260] vs 38.7% [74/191]). The adjusted odds ratio of smoking cessation was 2.41 (95% CI 2.07‐2.81), indicating a significant impact of digital peer support. Both higher duration of digital peer-supported app usage and increased posting frequency were positively associated with cessation success (P for trend