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Pivot Breath Sensor Increases Motivation to Quit Smoking

October 2, 2020
By Pivot
Person holding Pivot Breath Sensor with a 29 reading on the screen

Pivot Breath Sensor Significantly Increases Motivation to Quit Smoking

In a study of 234 participants, use of the Pivot personal Carbon Monoxide Breath Sensor resulted in a significant increase in motivation to quit, increase in quit attempts, and reduction in cigarette consumption.

REDWOOD CITY, CA, October 02, 2020 – The Pivot Breath Sensor was evaluated in a clinical trial involving 234 people who smoke cigarettes to determine its effects on smoking behavior and attitudes.1 During this 3-month study, participants demonstrated increased motivation to quit, favorable quit attempt rates, and reduced cigarettes per day—all of which significantly increase the likelihood of quitting smoking. The study, by Marler et al., was published in the open-access Journal of Medical Internet Research (JMIR Publications).

The Pivot Breath Sensor, created by Carrot Inc.*, is a personal, interactive, FDA-cleared, over-the-counter device that measures carbon monoxide (CO) in exhaled breath, a toxin that rapidly rises with cigarette consumption and then falls with abstinence. This first-of-its-kind sensor enables users to immediately link their smoking behavior to their CO values and track their progress in reducing or quitting smoking. The sensor can be used with or without a smartphone. In contrast to clinic-based CO sensors, the Pivot Breath Sensor is lightweight and pocket-sized, allowing it to be easily carried and used throughout the day. The sensor is a key component of Pivot’s comprehensive evidence-based digital tobacco cessation solution; it is able to connect via Bluetooth and integrate with the mobile app to support behavioral change. The Pivot program also includes nicotine replacement products, coaching from certified tobacco cessation specialists via secure in-app texting, and a moderated online community.

Researchers sought to assess the clinical outcomes of using the sensor without the comprehensive quit program, so participants were simply asked to review the educational material provided with the sensor, provide breath samples 4 times per day, and answer periodic study queries.

Motivation to quit smoking significantly increased among participants. At study conclusion, the number of participants who were seriously thinking of quitting tripled compared to study entry. This type of advancement in motivation has positive implications, almost doubling the likelihood that a person who smokes will take effective action to quit in the next 6 months.2,3

Nearly half of participants made at least one quit attempt (at least 24 hours of no smoking) and 39% reduced their cigarette consumption by at least 50%. Quit attempts are important, as increases in smoking cessation are driven in large part by increases in quit attempts.4 Accordingly, the CDC and the Healthy People initiative have identified increasing quit attempts as an important goal for tobacco control efforts.5,6  Reducing cigarettes per day by 50% is meaningful as such reduction has been shown to significantly increase the rates of quit attempts or cessation.7

More than 90% of participants indicated the sensor taught them about their CO levels and smoking behavior, and nearly 3 out of 4 reported that seeing their CO values made them want to quit smoking.

While not a primary endpoint in the study, 12% of participants reported they had quit smoking all together at the end of the 3-month study period.

“These study results show that the Pivot Breath Sensor helps build motivation to quit and prompts positive behavior change in people who smoke,” said Carrot Founder and CEO, David S. Utley, M.D. “While the majority of people who smoke know smoking is bad for them, messages about the health risks of smoking have yielded diminishing returns for some time. This study shows that seeing a quantified, dynamic, immediate measure of the direct effect of smoking has a positive impact on the participant. The associated shifts in motivation and smoking behavior are welcome milestones that make these individuals significantly more likely to quit smoking.”

The full Pivot program is available through self-insured employers and health plans to their respective employees and members, while the Pivot sensor will be offered directly to consumers by year-end. To learn more, visit

About Carrot Inc. and the Pivot program: Carrot is a digital health company delivering clinically-proven solutions that empower people to take control of their health. Carrot’s Pivot brand is an industry leader in tobacco and vaping cessation. Combining behavioral science, proprietary medical device technology, pharmacotherapy, community support, and dedicated coaching, we aim to help millions of people quit tobacco. Learn more at


  1. Marler JD, Fujii CA, Wong KS, Galanko JA, Balbierz DJ, Utley DS. Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study J Med Internet Res 2020;22(9):e22811 URL: doi: 10.2196/22811 PMID: 32894829
  2. Prochaska JO, Norcross JC, Diclemente C. Applying the stages of change. Psychother Aust 2013;19:15. [doi: 10.1093/med:psych/9780199845491.003.0034]
  3. Prochaska JO, Velicer WF, Prochaska JM, Johnson JL. Size, consistency and stability of stage effects for smoking cessation. Addict Behav 2004;29:207-213. PMID:14667431
  4. Zhu SH, Lee M, Zhuang YL, Gamst A, Wolfson T. Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades? Tob Control 2012;21:110–8. PMID:22345233
  5. Office of Disease Prevention and Health Promotion. Tobacco Use. URL: topics-objectives/topic/tobacco-use/objectives [accessed 2020-09-15]
  6. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014. In: Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014:1-141. URL:
  7. Hughes JR. Reduced smoking: an introduction and review of the evidence. Addiction 2000;95 Suppl 1:S3-S7. PMID:10723815

Media Contact

Laura Metzger

Upright Position Communications

Tel: +1-339-788-0128

Email: [email protected]

*Pivot Health Technologies Inc. was previously known as Carrot Inc. and changed names in 2022.

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