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Pivot Breathe Beats Control Program in Year-Long Randomized Controlled Trial

September 6, 2023
By Pivot
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Pivot’s smoking cessation quit rate reached 44% in a randomized controlled trial (RCT), with significantly higher biovalidated quit rates than the QuitGuide control program at one year.

One hundred eighty-eight people in the United States who smoke cigarettes participated in a randomized control trial coordinated by Pivot. They were divided into two groups: the intervention group used Pivot Breathe, and the control group used the gold standard tobacco cessation offering from the National Cancer Institutes (NCI), QuitGuide.

Data was self-reported via online questionnaires at 12, 26, and 52 weeks. Outcomes included quit rates, smoking behavior, confidence to quit, engagement and retention, and participant feedback. And now, the results are in!

Pivot Breathe users had significantly higher quit rates than the control group. 

Here’s some data from the trial:

  • 44% of Pivot Breathe users quit smoking at one year
  • 63% of Pivot Breathe users decreased the number of cigarettes smoked per day
  • Two times more Pivot Breathe users had a continuous biovalidated quit smoking rate than the control group

Keep reading for an in-depth look at the results and learn how Pivot Breathe can make your organization a healthier, happier, and more productive workplace.

Analyzing Control Trial Results

The randomized controlled trial, published in JMIR mHealth and uHealth, evaluated the health outcomes of 188 adults over a year. These individuals were randomized to participate in either Pivot Breathe or QuitGuide. 

The RCT measured outcomes for engagement and retention, attitudes towards quitting smoking, smoking behavior, and participant feedback. 

Participants were 21 or older and had smoked at least five cigarettes daily for 12 months. They also planned to quit smoking in 30 days and were comfortable using smartphones and apps. Additionally, participants were offered 12 weeks of free nicotine replacement therapy. 

Let's uncover the key discoveries:

Breakthrough quit rates: The Pivot group had significantly higher biovalidated quit rates throughout the study, at 12, 26, and 52 weeks. 

Steady progression: Pivot's quit rate rose consistently throughout the study (insert graph), showcasing the stark contrast of “cold turkey” attempts that average 3–5%.

Enduring nicotine abstinence: Pivot's biovalidated continuous abstinence rates were significantly higher (2x) than QuitGuide at 12 months, confirming program efficacy.

Increasing confidence: Confidence to quit is a crucial measurement of success. Throughout the 12 months, Pivot users' self-assuredness in overcoming nicotine challenges grew substantially from baseline, paving the way to success.

Higher engagement: Pivot users were more engaged than those who had QuitGuide, with significantly more (nearly double) app opens. 

Empowering nicotine reduction: 38% of Pivot users who hadn't entirely quit managed significant reductions of 50% or more in daily cigarette consumption, marking a substantial step towards healthier living. The ability to reduce cigarettes by more than 50% is a key marker and increases one’s likelihood to succeed in quitting.

“These results add to the growing body of scientific literature on the long-term outcomes of mobile smoking cessation programs,” Jennifer D. Marler, M.D., VP Clinical & Medical Affairs at Pivot said. “The data is encouraging and consistent, pointing to a critical role these types of programs can play in the larger societal effort to curb nicotine dependence.” 

Read the full abstract here.

Pivot Breathe: Customized Experience, Measurable Results

Tobacco remains the single most significant cause of preventable illness, disease, and death, with around 480,000 people in the United States dying from smoking-related diseases each year. Moreover, cigarettes take a massive toll on the economy. Smoking cost the U.S. more than $600 billion in 2018 – over $240 billion in healthcare spending and almost $372 billion in lost productivity.

“Smoking combustible tobacco remains a public health crisis, and therefore, it should be our number one public health priority to help people quit smoking,” David S. Utley, M.D., founder and CEO of Pivot said. Cigarettes are a causative agent in nearly all of the highest cost chronic health conditions.” 

We know the risks. We know the consequences. So, why do around 23% of working-age adults in the United States still smoke? It boils down to one hard fact: Quitting is hard. Nicotine is highly addictive, and it’s tough to succeed when doing it alone. Thankfully, there’s a solution.

As the industry’s most comprehensive digital tobacco cessation solution, Pivot Breathe provides members with evidence-based interventions via an easy-to-use mobile app.

“Pivot Breathe is a unique, evidence-based, and scalable tool to help people quit tobacco for good,” Dr. Utley said. “Delivery of an effective preventive service upstream is always more cost-effective and clinically effective than treating the downstream complications like cancer, diabetes, emphysema, and vascular disease.”

In addition to interactive lessons, Pivot Breathe users have access to:

  • The first FDA-cleared over-the-counter device to help people quit tobacco
  • Behavioral change mobile app 
  • Nicotine replacement therapy
  • Support from a peer community
  • Dedicated, expert health coach (Certified NBHWC)


In conjunction with prior research, the RCT demonstrates that Pivot Breathe is one of the most effective programs to help people quit tobacco and stay quit. These findings contribute substantively to the expanding reservoir of evidence that underscores the burgeoning significance of digital, app-based interventions for smoking cessation.

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