Exploring relationships among smoking cessation app use, smoking behavioral outcomes, and pharmacotherapy utilization among individuals who smoke cigarettes.

INTRODUCTION: Most individuals who smoke cigarettes are interested in quitting, but many are unable to quit. Fewer than one-third of individuals who smoke cigarettes attempt to quit using FDA-approved cessation methods, such as nicotine replacement therapy (NRT) and prescription medications. Smoking cessation apps (SCAs) provide individuals with personalized quit plans, information about smoking cessation treatments, craving management strategies, and other features. However, their relationship to NRT/prescription medication utilization and quit attempts is understudied.

METHODS: We conducted a longitudinal secondary data analysis using a subset of adults who smoked at least 100 cigarettes in their lifetime, currently smoked every day or some days, and planned to quit within a year. This subset was drawn from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study. We utilized Generalizing Estimating Equation models to examine the longitudinal associations between SCA use initiation and the following outcomes across 2014-2019: NRT, prescription medications, and quit attempts.

RESULTS: SCA use initiation was associated with greater odds of prescription medication utilization (AOR = 2.43, 95 % CI: 1.63, 3.64; p < 0.05). Likewise, SCA use initiation was associated with greater odds of making a quit attempt (AOR = 1.38, 95 % CI: 1.09, 1.76; p < 0.01), but not NRT utilization.

CONCLUSION: Among adults who regularly smoked cigarettes and had plans to quit, SCA use initiation was associated with prescription medication utilization and quit attempts but not NRT utilization. SCAs may have utility as a population-level intervention but specific features needed to be studied further.

ABBREVIATIONS: SCA, Smoking Cessation App; NRT, Nicotine Replacement Therapy.