Can interventions delivered by mobile phones help people to stop smoking?

Whittaker R, Borland R, Bullen C, Lin RB, McRobbie H, Rodgers A

Published Online:

October 7, 2009

More evidence is needed to determine if programmes delivered over mobile phones can help people to stop smoking. This review found text message mobile phone programmes to be effective in the short-term (six weeks), and a combined Internet-mobile phone programme to be effective up to 12 months.

Abstract (click to read)

Background:

Innovative effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes such as smoking cessation.

Objectives:

To determine whether mobile phone-based interventions are effective at helping people who smoke, to quit.

Search strategy:

We searched MEDLINE, EMBASE, Cinahl, PsycINFO, The Cochrane Library, the National Research Register and the ClinicalTrials register, with no restrictions placed on language or publication date.

Selection criteria:

We included randomized or quasi-randomized trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone.

Data collection and analysis:

Information on the specified quality criteria and methodological details was extracted using a standardised form. Participants who dropped out of the trials or were lost to follow up were considered to be smoking. Meta-analysis of the included studies was undertaken using the Mantel-Haenszel Risk Ratio fixed-effect method provided that there was no evidence of substantial statistical heterogeneity as assessed by the I2 statistic. Where meta-analysis was not possible, summary and descriptive statistics are presented.

Main results:

Four studies were excluded as they were small non-randomized feasibility studies, and two studies were excluded because follow up was less than six months. Four trials (reported in five papers) are included: a text message programme in New Zealand; a text message programme in the UK; and an Internet and mobile phone programme involving two different groups in Norway. The different types of interventions are analysed separately. When combined by meta-analysis the text message programme trials showed a significant increase in short-term self-reported quitting (RR 2.18, 95% CI 1.80 to 2.65). However, there was considerable heterogeneity in long-term outcomes, with the much larger trial having problems with misclassification of outcomes; therefore these data were not combined. When the data from the Internet and mobile phone programmes were pooled we found statistically significant increases in both short and long-term self-reported quitting (RR 2.03, 95% CI 1.40 to 2.94).

Authors' conclusions:

The current evidence shows no effect of mobile phone-based smoking cessation interventions on long-term outcome. While short-term results are positive, more rigorous studies of the long-term effects of mobile phone-based smoking cessation interventions are needed.

This record should be cited as:

Whittaker R, Borland R, Bullen C, Lin RB, McRobbie H, Rodgers A. Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006611. DOI: 10.1002/14651858.CD006611.pub2

Assessed as up to date:

June 29, 2009

Find the research

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Primary Review Group:

Tobacco Addiction Group

PEARLS - Practical Evidence About Real Life Situations (click to read)

Clinical question:

How effective are mobile phone-based interventions at helping smokers to quit?

Bottom line:

The interventions in this review included: a purely text message-based programme with automated proactive text messages and some reactive components (for help with cravings) and interactive (polls/quizzes) components; and an automated email/daily internet page and mobile phone text/audio message programme with proactive and reactive components. Text message mobile phone programmes were effective in the short term (6 weeks) only, and a combined internet and mobile phone programme was effective for up to 12 months (in terms of self-reported quitting).

Caveat:

In this review, only one study attempted biochemical verification of quitting at 6 months, and one at 6 weeks. In programmes aimed at young people, where minimal direct contact and anonymity appear to be desired elements, attempting verification may have adverse effects on the collection of follow-up data.

Context:

Innovative effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well-integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes, such as smoking cessation.

Cochrane Systematic Review:

Whittaker R et al. Mobile phone-based interventions for smoking cessation. Cochrane Reviews 2009, Issue 4. Article No. CD006611. DOI: 10.1002/14651858.CD006611.pub2. This review contains 4 studies involving 2601 participants.

Authored by:

Brian R McAvoy

Cochrane Primary Health Care Field

Health topics:

Lungs & airways > Smoking cessation > Non-pharmacological interventions

Lungs & airways > Smoking cessation > Psychological approaches

Tobacco, drugs, & alcohol dependence > Tobacco > Non-pharmacological interventions

Tobacco, drugs, & alcohol dependence > Tobacco > Psychological approaches

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Can interventions delivered by mobile phones help people to stop smoking?

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