Efficacy of Synchronous Telecare Compared to Cell Phone Application on Smoking Cessation Rates in a Low-Middle-income Country: A Pilot Randomized Trial

BACKGROUND:Limited studies compare the efficacy of different modes of telecare interventions for smoking cessation, especially in low-middle-income countries where smoking prevalence is highest. OBJECTIVES:This study aimed to evaluate the effectiveness of synchronous telecare compared to use of a cell phone application on smoking cessation rates, withdrawal syndrome, and psychological distress. METHODS:This study followed a parallel pilot randomized control trial design and was performed remotely utilizing digital platforms. 51 participants recruited in Brazil were randomly divided into two groups: the Synchronous Telecare Group [STG(n = 29)] and the Application Group [AppG(n = 22)]. Participants in the STG underwent treatment over the Google Meet platform. Participants in the AppG underwent treatment using solely the Smokerstop® cell phone application. Treatment lasted 10 weeks from baseline assessment. The primary outcome measure was abstinence rate, assessed via biweekly questionnaire. Relapse frequency, nicotine dependence, withdrawal syndrome, and psychological distress were assessed as secondary outcomes. Chi-square analyses were used to compare abstinence and relapse rates. Comparison analyses employed the unpaired student's t-test and the Mann-Whitney test in accordance with normality of the data. RESULTS:No differences were found between groups in abstinence rate (AppG:44.84%, STG:45.45%, p = 1.00) or relapse frequency (AppG: 1.00±1.11, STG: 0.79±1.08, p = 0.43). No differences in WSWS and HADS scores were found between groups following intervention. CONCLUSIONS:These results may aid in informing public health strategies, when supported by larger randomized control trials, to improve access to virtual smoking cessation treatments in regions of high smoking prevalence and limited healthcare resources, therefore contributing to global tobacco control.