TY  - JOUR
AU  - Scott-Sheldon, Lori A. J
AU  - Lantini, Ryan 
AU  - Jennings, Ernestine G
AU  - Thind, Herpreet
AU  - Rosen, Rochelle K
AU  - Salmoirago-Blotcher, Elena
AU  - Bock, Beth C
PY  - 2016
DA  - 2016/05/20
TI  - Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis
JO  - JMIR mHealth uHealth
SP  - e49
VL  - 4
IS  - 2
KW  - text messaging
KW  - smoking cessation
KW  - intervention
KW  - cigarette smoking
KW  - meta-analysis
AB  - 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. 
SN  - 2291-5222
UR  - http://mhealth.jmir.org/2016/2/e49/
UR  - https://doi.org/10.2196/mhealth.5436
UR  - http://www.ncbi.nlm.nih.gov/pubmed/27207211
DO  - 10.2196/mhealth.5436
ID  - info:doi/10.2196/mhealth.5436
ER  -