Tobacco Use: Mobile Phone-Based Cessation Interventions Archived Review

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends mobile phone-based interventions for tobacco cessation to increase tobacco use abstinence among people who want to quit.

Intervention

Mobile phone-based cessation interventions use interactive features to deliver evidence-based information, strategies, and behavioral support directly to tobacco users who want to quit. Typically, participants receive text messages that support their quit attempt, with message content changing over the course of the intervention.

Content may be developed or adapted for specific populations and communities. Messages may be tailored for individuals based on computer algorithms that match messages to information provided by the participant. Programs may be automated, and they may include text responses provided on demand to participants who feel an urge to smoke.

Mobile phone-based interventions may be used alone or with additional interventions.

CPSTF Finding and Rationale Statement

Read the full CPSTF Finding and Rationale Statement [PDF – 164 kB] for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

About The Systematic Review

The CPSTF finding is based on evidence published in 2009 (Whittaker et al., search period through December 2008) combined with more recent evidence (search period December 2008 August 2011).

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to reducing tobacco use and secondhand smoke exposure.

Summary of Results

More details about study results are available in the CPSTF Finding and Rationale Statement [PDF – 164 kB].

The systematic review included six studies.

Mobile phone interventions used alone increased cessation rates by a median of 2.9 percentage points at six months (3 studies).
Mobile phone interventions used in combination with internet-based components increased cessation rates by a median of 9 percentage points at six months (3 studies).

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.

Applicability

Applicability of the CPSTF finding to U.S. settings and populations is unclear and requires additional research. This is especially true for populations with disparities in tobacco use or access to cessation services and for older adults.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base.

Are interventions effective and cost-effective in the United States?
What are the costs of sustaining programs (e.g., promoting services to recruit participants)?
How would programs vary in effectiveness and cost-effectiveness by setting (e.g., health departments and organizations, health care systems, quitline services)?

Study Characteristics

Studies were conducted in Norway, New Zealand, and the United Kingdom.
All six included studies were randomized controlled trials and assessed self-reported (4 studies) or biochemically verified (2 studies) cessation outcomes at 6- or 12-month follow-up.
The median loss to follow-up rate was 10%.
One study included nicotine replacement therapy, which was provided to participants in both the intervention and comparison groups.

Analytic Framework

No content is available for this section.

Summary Evidence Table

No content is available for this section.

Included Studies

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Borland R, Balmford J, Benda P. Population-level effects of automated smoking cessation help programs: a randomized controlled trial. Addiction 2013; 108(3): 618-28.

Brendryen H, Drozd F, Kraft P. A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (Happy Ending): randomized controlled trial. Journal of Medical Internet Research 2008;10(5):e51.

Brendryen H & Kraft P. Happy Ending: a randomized controlled trial of a digital multi-media smoking cessation intervention. Addiction 2007;103:478-84.

Free C, Whittaker R, Knight R, et al. Txt2stop: a pilot randomized controlled trial of mobile phone-based smoking cessation support. Tobacco Control 2009;18:88-91.

Free C, Knight R, Robertson S, et al. Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomized trial. Lancet 2011;378:49-55.

Rodgers A, Corbett T, Bramley D, et al. Do u smoke after txt? Results of a randomized trial of smoking cessation using mobile phone text messaging. Tobacco Control 2005;14:255-61.

Whittaker R, Dorey E, Bramley D, et al. A theory-based video messaging mobile phone intervention for smoking cessation: randomized control trial. Journal of Medical Internet Research 2011;13(1):e10.

Search Strategies

No content is available for this section.

Review References

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

Considerations for Implementation

The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion. The Community Guide does not conduct systematic reviews of implementation.

Mobile phone-based interventions can be targeted to specific populations or automated to provide tailored content to individual users.
Programs should be scalable to system resources and user demand.
Ongoing advertising and service promotion is required to ensure use.
At the time of this review, smartphone applications did not provide, inform, or link to evidence-based treatments such as counseling, quitlines, and medications.
Smartphone applications may offer opportunities to coordinate additional cessation support around short text or video message-based interventions.
Barriers to use include concerns about the technologies (matching program, network, and user capabilities) and protections required to ensure confidentiality of participant information.

Crosswalks

Healthy People 2020

Healthy People 2020 includes the following objectives related to this CPSTF recommendation.