Efficacy of text-message delivered smoking cessation interventions: Meta-analysis

Background: Mobile technology provides new opportunities for health promotion communication. The purpose of this study was to conduct a current and extensive meta-analytic review of SMS (short message service) text-message based interventions for individual smoking cessation. Methods: Academic Search Complete, PsychInfo, PubMed, and Scopus were reviewed for articles meeting selection criteria: 1) randomized controlled trials, 2) measured smoking cessation, and 3) intervention primarily delivered through text-messaging.  Six month follow-up of seven-day point prevalence of smoking cessation was considered from selected studies. All analyses were conducted with intention-to-treat. A test for heterogeneity was conducted to measure the level of variation in the outcome measures. Both the fixed and random effects models were used to calculate the global outcome measure and confidence intervals. Results: Thirteen studies, from seven countries, were identified from 85 articles. Using a chi-square test for heterogeneity, the studies were found to be homogenous [X²=17.65 (p value=0.1267)]. The global odds ratios based on the fixed and random effects models concluded that interventions generally increased quit rates compared to controls, 1.38 [95% CI= 1.26, 1.52] and 1.41 [95% CI= 1.21, 1.64], respectively. Effect sizes generally decreased at longer follow-up periods. Conclusion: Given the intractability of smoking, an overall 38% increase in cessation suggests that text-based may be a promising way to improve smoking cessation efforts. This is particularly true given the relatively wide reach and low cost of SMS text-message interventions. Knowing the components that make SMS interventions efficacious will help program planners increase the effectiveness of such interventions.