BACKGROUND AND IMPLEMENTATION CHALLENGES: Tobacco addiction poses significant global health risks, however quitting is challenging and necessitates innovative approaches. A hybrid approach combining physical and virtual therapy could offer significant benefits. This study evaluates an in-person quit program with behavioural counseling and nicotine replacement therapy (NRT) supplemented by mobile application, integrating nudging, gamification, and cognitive behavioral therapy principles to empower individuals in their cessation journey and phone-call based follow up.
INTERVENTION OR RESPONSE: Participants (n=600) received in-person behavioral counseling or a combination of counseling and NRT, supported by a structured low cost follow-up mechanism in a community and hospital setting in India. Community health workers conducted monthly call-based check-ins to motivate participants and maintain accountability. The app served as a supplementary tool, enabling users to log tobacco consumption, monitor cravings and withdrawal symptoms. Nudging techniques redirected cravings toward engaging activities, while gamified elements like leaderboards and rewards reinforced motivation. A peer support system encouraged mutual accountability and emotional resilience.
RESULTS AND IMPACT: Preliminary results for the first 120 participants over a 6 months period showed that among two intervention groups (n=60 each), the NRT and counseling group achieved a 60% complete cessation rate (n=36) and a 40% reduction rate (n=24). The counseling-only group attained 48.3% complete cessation (n=29) and 51.7% reduction (n=31). While NRT showed a trend toward higher cessation rates, the difference was not statistically significant (χ²=1.69, p=0.194). Both approaches outperformed conventional cessation programs, which typically achieve 15-35% success rates. Regular follow-ups by healthcare workers significantly improved self-regulation and participant satisfaction.
CONCLUSIONS: This in-person quit program, supported by a mobile app, demonstrated higher quit rates than traditional methods, with both intervention modalities achieving approximately 1.7-2 times greater success. Behavioral counseling, NRT, and virtual follow-up support were critical in fostering motivation and accountability and the study will further examine the impact of combining virtual follow up with cessation therapy.