North America

Carrot's smoking cessation program helped 32% of study participants quit, reduced others' daily use

Carrot's Pivot program consists of an app, an FDA-cleared carbon monoxide breathalyzer, human coaching and pharmacotherapy encouragement.
By Dave Muoio
02:40 pm

Redwood, California-based Carrot has released new trial data supporting the performance of its digital smoking cessation program. Conducted by the company and published in JMIR mHealth and uHealth, they report that nearly a third of enrollees successfully quit smoking by the program’s end, with many who did not reporting a reduction in average cigarettes consumed per day.

“Demonstrating a quit rate of 32.4% exceeded our expectations, mainly because so many participants were not ready to quit smoking when they enrolled in the study,” Dr. Jennifer D. Marler, senior director of clinical and medical affairs at Carrot and the study’s lead author, said in a statement. “The data indicates that [our Pivot program] can increase motivation to quit, reduce cigarette consumption, and lead to a significant quit rate for a broad population of people who smoke, regardless of their readiness to quit.”

Carrot’s program consists of an app, an FDA-cleared carbon monoxide breathalyzer, human coaching and pharmacotherapy encouragement. It is divided into five sequential stages delivered over the course of 14.5 to 18.5 weeks.


The trial enrolled 319 adult smokers, of whom 272 completed an after-program questionnaire. At baseline, 66.5% said that they did not feel prepared to quit smoking within the first 30 days. Participants engaged with the Pivot program for an average of 12.4 weeks, with per-stage completion rates steadily decreasing from 88.7% for the first stage to 39.5% for the final stage.

Just under 80% of those who completed the protocol reported an attempt at quitting. One week abstinence was achieved by 32% of those enrolled and 37.5% of those whom completed the end questionnaire, while the recorded 30-day abstinence rates for those same groups was 27.6% and 32%. The researchers also observed a significant positive change in attitudes from baseline, and noted that 25.9% of those who were unable to quit did reduce their daily cigarette use by 50% or more.


From October 2017 to March 2018, the researchers enrolled US smokers aged 18 to 65 years through online advertisements. Participants were required to own a smartphone, speak English and smoke five or more cigarettes per day. These participants completed their registration and baseline questionnaire online, and received the breathalyzer in the mail.

Each was guided through the program within the downloaded Pivot app, and had access to customer service. Participants received monetary compensation for each completed study questionnaire and upon returning their device. Researchers collected and analyzed data regarding participants’ characteristics, engagement with and completion of the program, attitudes toward quitting and changes in smoking behavior.


Carrot jumped into the spotlight in late 2017 when its digital carbon monoxide breath sensor became the first device approved by the FDA for use in over-the-counter smoking cessation programs. About a year later, the company announced $25 million in new funding led by Johnson & Johnson Innovation.

But smoking cessation has been a longtime goalpost for apps, wearables and other digital health platforms, and one that has attracted its fair share of backing. Ro, for instance, announced in 2018 that it would be using an $88 million investment to launch an app-based smoking cessation platform called Zero.


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