Background Smoking cessation apps and electronic cigarettes have emerged as potentially effective tools for smokers motivated to quit. Nuumi, a novel intervention, integrates app-based behavioral therapy and an electronic cigarette. Using secondary data from a single-arm pilot trial evaluating the intervention, we investigated the degree to which users engaged with the program’s features, and the relationships between feature utilization and smoking abstinence during the first 8 weeks of the trial. Features included (1) behavioral therapy lessons, (2) meditation audios, (3) a toolbox, (4) progress tracking, and (5) an electronic cigarette. Outcomes were self-reported 7-day point prevalence abstinence from smoking 4 weeks and 8 weeks after program initiation. Self-reported smoking abstinence data and app utilization data of 62 participants were analyzed. Multiple univariate logistic regressions were performed with total program engagement and feature utilization as predictor variables, and 4-week and 8-week post-baseline smoking abstinence rates as dependent variables. Results Four weeks and eight weeks after program initiation, 35% (n = 22) of participants reported abstinence. Higher total engagement predicted higher likelihood of abstinence at 4 weeks (OR = 2.73, 95% CI [1.53, 5.70], p = 0.002), and 8 weeks follow-up (OR = 1.52, 95% CI [1.10, 2.22], p = 0.017). Four weeks after program initiation, significant feature-level predictors of smoking cessation included the number of therapy lessons completed (OR = 1.13, 95% CI [1.04, 1.24], p = 0.010), meditations completed (OR = 1.54, 95% CI [1.11, 2.30], p = 0.025), the number of times the progress tracking feature was accessed OR = 1.02, 95% CI [1.00, 1.03], p = 0.036), and the number of days the electronic cigarette was used (OR = 1.30, 95% CI [1.21, 1.58], p = 0.010). Eight weeks after initiation, only electronic cigarette use was predictive of smoking abstinence (OR = 1.06, 95% CI [1.02, 1.12], p = 0.048). Conclusion The intervention may have potential to support smokers motivated to quit. With respect to program features, use of the electronic cigarette may promote sustained cigarette abstinence; however, the association between behavioral therapy features and smoking abstinence may disappear over time. Measures to increase user engagement should be explored, and future research should test the intervention using a randomized controlled trial. Trial registration German Clinical Trials Register <a href="https://drks.de/search/de/trial/DRKS00032652">DRKS00032652</a>, registered prospectively 09/15/2023.

Feature-level analysis of a novel smoking cessation program integrating app-based behavioral therapy and an electronic cigarette

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2025年2月18日

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Helen Schiek,
Tobias Esch,
Cosima Hoetger

摘要

Background

Smoking cessation apps and electronic cigarettes have emerged as potentially effective tools for smokers motivated to quit. Nuumi, a novel intervention, integrates app-based behavioral therapy and an electronic cigarette. Using secondary data from a single-arm pilot trial evaluating the intervention, we investigated the degree to which users engaged with the program’s features, and the relationships between feature utilization and smoking abstinence during the first 8 weeks of the trial. Features included (1) behavioral therapy lessons, (2) meditation audios, (3) a toolbox, (4) progress tracking, and (5) an electronic cigarette. Outcomes were self-reported 7-day point prevalence abstinence from smoking 4 weeks and 8 weeks after program initiation. Self-reported smoking abstinence data and app utilization data of 62 participants were analyzed. Multiple univariate logistic regressions were performed with total program engagement and feature utilization as predictor variables, and 4-week and 8-week post-baseline smoking abstinence rates as dependent variables.

Results

Four weeks and eight weeks after program initiation, 35% (n = 22) of participants reported abstinence. Higher total engagement predicted higher likelihood of abstinence at 4 weeks (OR = 2.73, 95% CI [1.53, 5.70], p = 0.002), and 8 weeks follow-up (OR = 1.52, 95% CI [1.10, 2.22], p = 0.017). Four weeks after program initiation, significant feature-level predictors of smoking cessation included the number of therapy lessons completed (OR = 1.13, 95% CI [1.04, 1.24], p = 0.010), meditations completed (OR = 1.54, 95% CI [1.11, 2.30], p = 0.025), the number of times the progress tracking feature was accessed OR = 1.02, 95% CI [1.00, 1.03], p = 0.036), and the number of days the electronic cigarette was used (OR = 1.30, 95% CI [1.21, 1.58], p = 0.010). Eight weeks after initiation, only electronic cigarette use was predictive of smoking abstinence (OR = 1.06, 95% CI [1.02, 1.12], p = 0.048).

Conclusion

The intervention may have potential to support smokers motivated to quit. With respect to program features, use of the electronic cigarette may promote sustained cigarette abstinence; however, the association between behavioral therapy features and smoking abstinence may disappear over time. Measures to increase user engagement should be explored, and future research should test the intervention using a randomized controlled trial.

Trial registration

German Clinical Trials Register DRKS00032652, registered prospectively 09/15/2023.