Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

Abstract

BackgroundThe aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines.MethodsThis review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of “Internet,” “web-based,” and “smoking cessation intervention” and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.ResultsForty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15–2.21, I2=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63–1.10, I2=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25–3.52, I2=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97–1.87, I2=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79–1.13, I2=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03–1.31, I2=76.7%).ConclusionInternet interventions are superior to other broad reach cessation interventions (ie, print materials), equivalent to other currently recommended treatment modes (telephone and in-person counseling), and they have an important role to play in the arsenal of tobacco-dependence treatments.

Feasibility of biochemical verification in a web-based smoking cessation study

“…First, the response rate was low despite financial incentives, perhaps due to a lack of additional telephone follow-up which has yielded higher response rates in our previous research (36). High levels of attrition are common in studies of digital interventions (24, 25), making our results potentially informative to others looking to estimate the number of cases available for biochemical verification. We also note that roughly a third of participants reporting 7-day ppa did not return a saliva sample, potentially because they knowingly misreported their smoking status.…”

“…However, trials of digital interventions are often ill-suited for biochemical verification. Participants are usually recruited from the general population (vs. special populations) and have minimal direct interaction with study staff, and interventions are often self-guided and less intensive (24-26). Given the broad, national reach and scalability of digital interventions, such trials also often involve large, geographically diverse samples, posing additional challenges for biomarker collection.…”

How did smokers respond to standardised cigarette packaging with new, larger health warnings in the United Kingdom during the transition period? A cross-sectional online survey

“…This is a missed opportunity given that not all smokers will necessarily want to, or be in a position to, access a stop-smoking website; approximately 10% of adults in the UK have never used the internet (Office for National Statistics, 2017). In addition, a systematic review and meta-analysis of internet interventions for smoking cessation found that in terms of abstinence from smoking there were no statistically significant differences in comparison with counselling delivered via telephone interventions (Graham et al 2016).…”

Aliança Terapêutica nas Terapias Cognitivo-comportamentais por Videoconferência: uma Revisão da Literatura

“…Atualmente podem ser encontramos na literatura um número crescente de estudos sobre intervenções por internet de modo autoaplicado, assíncrona e sín-crona, para diferentes problemas (Graham et al, 2016;Zhao, Lustria, & Hendrickse, 2017). Porém, em nossa revisão foram encontrados poucos estudos que avaliassem a aliança terapêutica nas psicoterapias assíncronas (não simultâneas) e síncronas (simultâneas), indicando a necessidade de mais estudos para elucidar sobre a aliança nesta modalidade de tratamento.…”