Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis

BackgroundTobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation ac...

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Main Authors: Scott-Sheldon, Lori A. J, Lantini, Ryan, Jennings, Ernestine G, Thind, Herpreet, Rosen, Rochelle K, Salmoirago-Blotcher, Elena, Bock, Beth C
Format: Article
Language:English
Published: JMIR Publications 2016-05-01
Series:JMIR mHealth and uHealth
Online Access:http://mhealth.jmir.org/2016/2/e49/
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author Scott-Sheldon, Lori A. J
Lantini, Ryan
Jennings, Ernestine G
Thind, Herpreet
Rosen, Rochelle K
Salmoirago-Blotcher, Elena
Bock, Beth C
author_facet Scott-Sheldon, Lori A. J
Lantini, Ryan
Jennings, Ernestine G
Thind, Herpreet
Rosen, Rochelle K
Salmoirago-Blotcher, Elena
Bock, Beth C
author_sort Scott-Sheldon, Lori A. J
collection DOAJ
description BackgroundTobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. ObjectiveThe purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. MethodsElectronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. ResultsThe meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet. ConclusionsThe evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority.
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spelling doaj.art-9122599625f74a5e9b0f795639ffe53e2022-12-21T23:19:47ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222016-05-0142e4910.2196/mhealth.5436Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-AnalysisScott-Sheldon, Lori A. JLantini, RyanJennings, Ernestine GThind, HerpreetRosen, Rochelle KSalmoirago-Blotcher, ElenaBock, Beth CBackgroundTobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. ObjectiveThe purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. MethodsElectronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. ResultsThe meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet. ConclusionsThe evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority.http://mhealth.jmir.org/2016/2/e49/
spellingShingle Scott-Sheldon, Lori A. J
Lantini, Ryan
Jennings, Ernestine G
Thind, Herpreet
Rosen, Rochelle K
Salmoirago-Blotcher, Elena
Bock, Beth C
Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
JMIR mHealth and uHealth
title Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
title_full Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
title_fullStr Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
title_full_unstemmed Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
title_short Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
title_sort text messaging based interventions for smoking cessation a systematic review and meta analysis
url http://mhealth.jmir.org/2016/2/e49/
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