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This study aimed to measure whether medications approved by the US Food and Drug Administration (FDA) for smoking cessation would further enhance the efficacy of iCanQuit, relative to its parent trial comparator\u2014the National Cancer Institute's (NCI's) QuitGuide app.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of the entire parent trial sample of a two\u2010group (iCanQuit and QuitGuide), stratified, doubled\u2010blind RCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Participants who reported using an FDA\u2010approved cessation medication on their own (<jats:italic>n<\/jats:italic>\u00a0=\u2009619) and those who reported no use of cessation medications (<jats:italic>n<\/jats:italic>\u00a0=\u20091469).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were randomized to receive iCanQuit app or NCI's QuitGuide app.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Use of FDA\u2010approved medications was measured at 3\u2009months post\u2010randomization. Smoking cessation outcomes were measured at 3, 6 and 12\u2009months. The primary outcome was 12\u2010month self\u2010reported 30\u2010day point prevalence abstinence (PPA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The data retention rate at the 12\u2010month follow\u2010up was 94.0%. Participants were aged 38.5\u2009years, 71.0% female, 36.6% minority race\/ethnicity, 40.6% high school or less education, residing in all 50 US States and smoking 19.2 cigarettes\/day. The 29.6% of all participants who used medications were more likely to choose nicotine replacement therapy (NRT; 78.8%) than other cessation medications (i.e. varenicline or bupropion; 18.3 and 10.5%, respectively) and use did not differ by app treatment assignment (all <jats:italic>P<\/jats:italic>\u00a0&gt;\u20090.05). There was a significant (<jats:italic>P<\/jats:italic>\u00a0=\u20090.049) interaction between medication use and app treatment assignment on PPA. Specifically, 12\u2010month quit rates were 34% for iCanQuit versus 20% for QuitGuide [odds ratio (OR)\u2009=\u20092.36, 95% confidence interval (CI)\u2009=\u20091.59, 3.49] among participants reporting any medication use, whereas among participants reporting no medication use, quit rates were 28% for iCanQuit versus 22% for QuitGuide (OR\u2009=\u20091.41, 95% CI\u2009=\u20091.09, 1.82). Results were stronger for those using only NRT: 40% quit rates for iCanQuit versus 18% quit rates for QuitGuide (OR\u2009=\u20093.57, 95% CI\u2009=\u20092.20, 5.79).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The iCanQuit smartphone app for smoking cessation was more efficacious than the QuitGuide smartphone app, regardless of whether participants used medications to aid cessation. Smoking cessation medications, especially nicotine replacement therapy, might enhance the efficacy of the iCanQuit app.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16396","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T23:38:04Z","timestamp":1701128284000},"page":"664-676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Do medications increase the efficacy of digital interventions for smoking cessation? 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