{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:08:44Z","timestamp":1782846524928,"version":"3.54.5"},"reference-count":51,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Completion rates for smoking cessation treatments under Japan\u2019s national health insurance system remain suboptimal. A workplace cessation program, combining nicotine gum or patches with a group-based digital peer-supported app, has reported high cessation success rates. Although nicotine dependence is generally associated with lower cessation success, and self-confidence is generally associated with higher success, these associations may differ by tobacco product type. Evidence on these relationships in app-based cessation programs remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to examine the independent and combined associations of nicotine dependence and self-confidence in quitting with smoking cessation success among cigarette-only smokers, heated tobacco product\u2013only users, and dual users.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study used data from a workplace cessation program in Japan. Participants were eligible if they were employed, owned a smartphone, and self-enrolled in the program. Recruitment was conducted through workplace promotion and individual outreach, primarily via email from companies. The program combined a digital peer-support app with nicotine gum or patches, adjusted according to cigarette consumption. The app included anonymous peer-support group chats of up to 5 participants, where participants shared progress, photos, and comments. Nicotine dependence was assessed by the time to the first cigarette after waking (high: \u226430 min; low: >30 min). Self-confidence for quitting was rated on a 0\u201010 scale and dichotomized at the median. A 4-level variable combined nicotine dependence and self-confidence for quitting. Logistic regression analyses were conducted by tobacco product type, and odds ratios (ORs) and 95% CIs were estimated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 2143 participants were included in the analysis. Their mean age was 46.5 (SD 10.9) years, and approximately 90% were men. Overall cessation success was 53.8% (1152\/2143). Participants with high self-confidence had a higher cessation success rate than those with low self-confidence (529\/834, 63.4% vs 623\/1309, 47.6%), with an OR of 1.81 (95% CI 1.55\u20102.12). Nicotine dependence was significantly associated with cessation success only among cigarette-only smokers; those with low nicotine dependence had a higher OR than those with high dependence (OR 1.59, 95% CI 1.07\u20102.37). Across all tobacco product types, the subgroup with low nicotine dependence and high self-confidence showed the highest cessation success, followed by the subgroup with high nicotine dependence but high self-confidence.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n By distinguishing cigarette-only smokers, heated tobacco product\u2013only users, and dual users in a workplace cessation program, this study provides novel, product-specific evidence regarding nicotine dependence and self-confidence related to cessation success. This study extends prior research beyond cigarette-only smokers by examining tobacco user groups and suggests that self-confidence may predict cessation across tobacco product types, whereas the role of nicotine dependence may be product-specific. These findings may inform tailored, scalable smoking-cessation support in workplaces; however, they should be interpreted with caution because cessation outcomes were self-reported.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/84792","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T20:46:53Z","timestamp":1779223613000},"page":"e84792-e84792","source":"Crossref","is-referenced-by-count":0,"title":["Nicotine Dependence and Quit Self-Confidence in a Smoking Cessation Program Using a Group-Based Digital Peer-Supported App and Cigarette Consumption\u2013Adjusted Nicotine Aids Among Japanese Workers: Retrospective Cohort Study"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8461-4488","authenticated-orcid":false,"given":"Shota","family":"Yoshihara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8083-255X","authenticated-orcid":false,"given":"Kayoko","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8674-3476","authenticated-orcid":false,"given":"Chiaki","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8848-6329","authenticated-orcid":false,"given":"Shin","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2006-7918","authenticated-orcid":false,"given":"Satoru","family":"Amano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0692-9769","authenticated-orcid":false,"given":"Daichi","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9947-8984","authenticated-orcid":false,"given":"Ying","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6317-3904","authenticated-orcid":false,"given":"Hiroshi","family":"Yamato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"issue":"9796","key":"R1","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1016\/S0140-6736(11)61055-6","article-title":"What has made the population of Japan healthy?","volume":"378","author":"Ikeda","journal-title":"Lancet"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2020072","article-title":"An age-period-cohort analysis of the difference in smoking prevalence between urban and non-urban areas in Japan (2004-2019)","volume":"42","author":"Okui","journal-title":"Epidemiol Health"},{"issue":"10082","key":"R3","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1016\/S0140-6736(17)30819-X","article-title":"Smoking prevalence and attributable disease burden in 195 countries and territories, 1990\u20132015: a systematic analysis from the Global Burden of Disease Study 2015","volume":"389","author":"Reitsma","journal-title":"The Lancet"},{"key":"R4","unstructured":"Summary of the results of the national health and nutrition survey in Japan [Report in Japanese]. 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