Efficacy of a CBT-based WeChat Mini-Program smoking cessation intervention (‘Quit for Heart’) tailored for CVD patients in China: a randomised controlled pilot study (Preprint)

BACKGROUND Smoking cessation is critical for Chinese patients with cardiovascular disease (CVD) or CVD risk factors, yet the efficacy of smartphone-delivered interventions for this group remains to be evaluated. OBJECTIVE To evaluate the efficacy of the 12-week smartphone-delivered CBT-based programme ("Quit for Heart") for smoking cessation among Chinese CVD patients. METHODS A two-arm, parallel-group, individually randomised, double-blind, controlled pilot trial. 108 participants (from 214 randomised) with CVD/CVD risk factors in China were analysed for data integrity. Intervention group received CBT modules, personalized quit plans, and progress tracking; control group got automated reminders. Assessments (during intervention/follow-up) included primary outcome (biologically verified continuous smoking abstinence at week 26 after quit date) and secondary outcomes (seven-day point prevalence abstinence, self-reported continuous abstinence, physiological parameters [blood pressure, heart rate], predictive factors [baseline psychological metrics, disease profiles]). Assessments occurred during the intervention and follow-up. RESULTS No significant group differences in abstinence (adjusted OR range: 0.56–1.04; p=0.14–0.87) but better trends for intervention. Survival analysis showed intervention group’s longer relapse-free duration trend (log-rank p=0.095). DBP moderately decreased with abstinence (Cohen’s d: -0.63 to -0.72 at weeks 2–4). Baseline anxiety (DASS; OR=35.18, p=0.045) and lower quit will (OR=0.003–0.145, p=0.08–0.086) predicted relapse. Anxiety correlated with SBP elevation (β=3.93, p<0.05), depression with heart rate increases (β=4.27, p<0.05). Obesity elevated BP (SBP β=9.83, DBP β=8.34; p<0.01), hyperlipidemia lowered it (β=-3.61 to -5.10, p<0.05). Attrition exceeded 80% by week 26. CONCLUSIONS "Quit for Heart" demonstrated potential feasibility for smoking cessation in this high-attrition pilot study. Baseline anxiety, disease profile and motivation levels predicted relapse. Future research requires enhanced retention strategies and objective outcome validation. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT06747182. Website: https://clinicaltrials.gov/study/NCT06747182