Back to Journals » Substance Abuse and Rehabilitation » Volume 7

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

Authors Graham A, Carpenter K, Cha S, Cole S, Jacobs M, Raskob M, Cole-Lewis H

Received 1 December 2015

Accepted for publication 12 February 2016

Published 18 May 2016 Volume 2016:7 Pages 55—69


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Professor Li-Tzy Wu

Amanda L Graham,1,2 Kelly M Carpenter,3 Sarah Cha,1 Sam Cole,3 Megan A Jacobs,1 Margaret Raskob,3 Heather Cole-Lewis,4,5

1Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC, 2Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, 3Alere Wellbeing, Seattle, WA, 4Johnson & Johnson Health and Wellness Solutions, Inc., New Brunswick, NJ, 5ICF International, Rockville, MD, USA

Background: The 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.
Methods: This 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.
Results: Forty 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%).
Conclusion: Internet 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.

Keywords: systematic review, meta-analysis, Internet, smoking cessation, tobacco control 

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]