JMIR Mhealth Uhealth. 2023 Sep 12;11:e48253. doi: 10.2196/48253.
Mobile phone-based cessation interventions have emerged as a promising alternative for smoking cessation, while evidence of the efficacy of mobile phone-based smoking cessation programs among young people is mixed.
This study aimed to determine the efficacy of mobile phone-based interventions compared to usual practice or assessment-only controls on smoking cessation in young people.
In this systematic review and meta-analysis, we searched Cochrane Library, Embase, PubMed, and Web of Science on March 8, 2023. We included randomized controlled trials that examined the efficacy of mobile phone-based interventions on smoking cessation in young people (age ≤30 years). The risk of bias was assessed with Cochrane Risk of Bias 2.
A total of 13 eligible studies, comprising 27,240 participants, were included in this analysis. The age range of the participants was between 16 and 30 years. Nine studies were SMS text messaging interventions, and 4 studies were app-based interventions. The duration of the smoking cessation intervention varied from 5 days to 6 months. The included studies were conducted in the following countries: the United States, China, Sweden, Canada, Switzerland, and Thailand. The meta-analysis revealed that SMS text messaging interventions significantly improved continuous abstinence rates compared to inactive control conditions (risk ratio [RR] 1.51, 95% CI 1.24-1.84). The subgroup analysis showed pooled RRs of 1.90 (95% CI 1.29-2.81), 1.64 (95% CI 1.23-2.18), and 1.35 (95% CI 1.04-1.76) for continuous abstinence at the 1-, 3-, and 6- month follow-up, respectively. Pooling across 7 studies, SMS text messaging interventions showed efficacy in promoting 7-day point prevalence abstinence (PPA), with an RR of 1.83 (95% CI 1.34-2.48). The subgroup analysis demonstrated a significant impact at the 1- and 3-month follow-ups, with pooled RRs of 1.72 (95% CI 1.13-2.63) and 2.54 (95% CI 2.05-3.14), respectively, compared to inactive control conditions. However, at the 6-month follow-up, the efficacy of SMS text messaging interventions in promoting 7-day PPA was not statistically significant (RR 1.45, 95% CI 0.92-2.28). In contrast, app-based interventions did not show significant efficacy in promoting continuous abstinence or 7-day PPA. However, it is important to note that the evidence for app-based interventions was limited.
SMS text messaging-based smoking cessation interventions compared to inactive controls were associated with abstinence among young people and could be considered a viable option for smoking cessation in this population. More research is needed on smoking cessation apps, especially apps that target young people. Future research should focus on identifying the most effective mobile phone-based cessation approaches and on developing strategies to increase their uptake and intention.
基于移动电话的戒烟干预措施已成为戒烟的一种有前途的替代方法，而移动电话戒烟计划在年轻人中的疗效证据参差不齐。
本研究旨在确定基于移动电话的干预措施与年轻人的常规实践或仅评估对照相比在戒烟方面的疗效。
在这项系统评价和荟萃分析中，我们于 2023 年 3 月 8 日在 Cochrane 图书馆、Embase、PubMed 和 Web of Science 上进行了搜索。我们纳入了评估基于移动电话的干预措施对年轻人（≤30 岁）戒烟效果的随机对照试验。使用 Cochrane 偏倚风险 2 评估偏倚风险。
共有 13 项符合条件的研究，包含 27240 名参与者，被纳入了本分析。参与者的年龄范围在 16 岁至 30 岁之间。9 项研究为短信干预，4 项研究为应用程序干预。戒烟干预的持续时间从 5 天到 6 个月不等。纳入的研究在以下国家进行：美国、中国、瑞典、加拿大、瑞士和泰国。荟萃分析显示，与非活动对照相比，短信干预显著提高了持续戒烟率（风险比 [RR] 1.51，95%置信区间 [CI] 1.24-1.84）。亚组分析显示，在 1 个月、3 个月和 6 个月的随访中，分别有 1.90（95%CI 1.29-2.81）、1.64（95%CI 1.23-2.18）和 1.35（95%CI 1.04-1.76）的汇总 RR 用于持续戒烟。综合 7 项研究结果，短信干预在促进 7 天点流行率戒烟方面具有疗效，RR 为 1.83（95%CI 1.34-2.48）。亚组分析显示，与非活动对照相比，在 1 个月和 3 个月的随访中，RR 分别为 1.72（95%CI 1.13-2.63）和 2.54（95%CI 2.05-3.14），均有显著影响，但在 6 个月的随访中，短信干预在促进 7 天点流行率戒烟方面的疗效无统计学意义（RR 1.45，95%CI 0.92-2.28）。相比之下，基于应用程序的干预措施在促进持续戒烟或 7 天点流行率方面并未显示出显著疗效。然而，值得注意的是，基于应用程序的干预措施的证据有限。
与非活动对照组相比，基于短信的戒烟干预措施与年轻人的戒烟有关，可能是该人群戒烟的一种可行选择。需要更多关于戒烟应用程序的研究，特别是针对年轻人的应用程序。未来的研究应侧重于确定最有效的基于移动电话的戒烟方法，并制定策略来提高其接受度和意愿。
