Efficacy of Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: A Randomized Controlled Trial

Abstract

Background and aims Smoking is the leading preventable cause of premature death in China, yet less than 10% of smokers seeking to quit receive treatment. This study aimed to test the efficacy of a cognitive behavioral therapy (CBT)-based smoking cessation intervention ('Smokefree Life') via a smartphone app in China. Design A digital, parallel, single-blind, two-arm (1:1) randomized controlled trial. Setting This trial was conducted via 'Smokefree Life' app in the whole of mainland of China between 13 December 2021 and 15 April 2023. Participants Chinese-speaking adult smokers (925 males, 102 females, mean age 35.0 ± 6.7) willing to quit within one month were recruited via WeChat, survey sampling and referral from doctors, friends and family and randomized in a 1:1 ratio. Intervention The intervention group (n = 523) received a 13-14 week CBT-based smoking cessation intervention via smartphone app and the control group (n = 504) received only control messages. All participants were followed for 26 weeks post-quit date. Measurements The primary outcome was biochemically validated continuous abstinence at 26 weeks. Secondary outcomes were self-reported 7-day abstinence and continuous abstinence at 26 weeks. Findings By intention-to-treat analysis, the biochemically verified 26-week continuous abstinence rate was statistically significantly higher in the intervention group (6.50%) compared with the control group (2.58%) (odds ratio = 2.63, 95% confidence interval = 1.40-5.22, P = 0.0037). Self-reported 7-day and continuous abstinence rates were also consistently higher in the intervention group across follow-ups (all P Conclusions The 'Smokefree Life' app-based smoking cessation intervention statistically significantly improved 6-month biochemically confirmed quit rates among adult smokers in China.

Contribution highlights

• This study aimed to test the efficacy of a cognitive behavioral therapy (CBT)-based smoking cessation intervention ('Smokefree Life') via a smartphone app in China.

Extracted from the public abstract; no claims have been added.

Code and data

Publication metadata

DOI

10.1111/add.70239

PMID

41218997

PMCID

PMC12887926

Volume

121

Issue

3

Pages / article

575-585

Version relationship

No separate preprint-to-publication relationship is currently recorded.

BibTeX

@article{Tang2026Efficacycognitive,
  title = {Efficacy of Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: A Randomized Controlled Trial},
  author = {Jinsong Tang and Xiaocong Liu and Shanshan Chen and Yunkai Sun and Minzhe Zhu and Zitang Zhou and Yueheng Liu and Jie Yang and Wei Chen and Yanhui Liao},
  journal = {Addiction},
  year = {2026},
  url = {https://onlinelibrary.wiley.com/doi/10.1111/add.70239},
  doi = {10.1111/add.70239},
  pmid = {41218997},
  volume = {121},
  number = {3},
  pages = {575--585}
}