@Article{info:doi/10.2196/mhealth.5436,
author="Scott-Sheldon, Lori A. J
and Lantini, Ryan 
and Jennings, Ernestine G
and Thind, Herpreet
and Rosen, Rochelle K
and Salmoirago-Blotcher, Elena
and Bock, Beth C",
title="Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis",
journal="JMIR mHealth uHealth",
year="2016",
month="May",
day="20",
volume="4",
number="2",
pages="e49",
keywords="text messaging; smoking cessation; intervention; cigarette smoking; meta-analysis",
abstract="Background: Tobacco 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. Objective: The 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. Methods: Electronic 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. Results: The 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. Conclusions: The 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. ",
issn="2291-5222",
doi="10.2196/mhealth.5436",
url="http://mhealth.jmir.org/2016/2/e49/",
url="https://doi.org/10.2196/mhealth.5436",
url="http://www.ncbi.nlm.nih.gov/pubmed/27207211"
}