Computer-based and Internet-based smoking cessation interventions are effective for adult smokers, concludes a meta-analysis in the May 26, 2009, Archives of Internal Medicine.
The investigators searched the literature for randomized controlled trials of Web- or computer-based smoking cessation programs for smokers. All studies included at least 3 months' follow-up data; biochemical confirmation was not necessary for inclusion. The main outcomes of interest were abstinence rates, including point-prevalence, sustained, prolonged, and continuous abstinence. The lead author was Dr Seung-Kwon Myung of National Cancer Center, Goyang, South Korea.
The review identified 22 trials included 29,549 smokers: 16,050 assigned to Web- or computer-based programs and 13,499 to control groups. The smoking cessation intervention was Web-based in 9 studies and computer-based in 13.
On random-effects meta-analysis, the study interventions had a significant effect on smoking cessation, with a 1.44 relative risk (RR) of abstinence. The Web-based and computer-based programs had similar RRs: 1.40 and 1.48, respectively. At 12 months' follow-up, abstinence rates in the intervention groups were around 10% (compared to 6% in the control groups).
The effects were similar in most subgroups analyzed, including studies of higher versus lower methodologic rigor, stand-alone versus supplemental interventions, differing abstinence measures, and differing lengths of follow-up. The exception was adolescent smokers, in whom the Web- and computer-based programs did not significantly increase abstinence rates.
Previous randomized trials of computer- or Internet-based smoking cessation interventions have yielded mixed results. The new meta-analysis suggests a significant benefit of such interventions—smoking cessation rates are about 50% higher than in intervention groups.
The results provide "sufficient clinical evidence to support the use of Web- and computer-based smoking cessation programs for adult smokers," the investigators conclude.
Arch Intern Med. 2009;169:929-937.
