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Systematic review
Systematic review and meta-analysis of text messaging interventions to support tobacco cessation
  1. Cheneal Puljević1,
  2. Isabel Meciar1,
  3. Alice Holland1,
  4. Daniel Stjepanović1,2,
  5. Centaine L Snoswell3,4,
  6. Emma E Thomas3,4,
  7. Kylie Morphett1,
  8. Heewon Kang1,5,
  9. Gary Chan1,2,
  10. Etienne Grobler6,
  11. Coral E Gartner1
  1. 1 NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
  2. 2 National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
  3. 3 Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
  4. 4 Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
  5. 5 Seoul National University Institute of Health and Environment, Seoul, South Korea
  6. 6 Department of Psychology, University of Cape Town, Cape Town, South Africa
  1. Correspondence to Dr Cheneal Puljević, School of Public Health, The University of Queensland School of Public Health, Herston, Queensland, Australia; c.puljevic{at}uq.edu.au

Abstract

Objective To review randomised controlled trials (RCTs) investigating the effectiveness of text message-based interventions for smoking cessation, including the effects of dose (number of text messages) and concomitant use of behavioural or pharmacological interventions.

Data sources We searched seven databases (PubMed, CINAHL, PsycINFO, Scopus, EMBASE, Cochrane Library and Web of Science), Google Scholar and the reference lists of relevant publications for RCTs. Eligible studies included participants aged ≥15 years who smoked tobacco at enrolment.

Study selection One reviewer screened titles and abstracts and two reviewers independently screened full texts of articles.

Data extraction One of three reviewers independently extracted data on study and intervention characteristics and smoking abstinence rates using Qualtrics software.

Data synthesis 30 of the 40 included studies reported higher rates of smoking cessation among those receiving text messaging interventions compared with comparators, but only 10 were statistically significant. A meta-analysis of seven RCTs found that participants receiving text messages were significantly more likely to quit smoking compared with participants in no/minimal intervention or ‘usual care’ conditions (risk ratio 1.87, 95% CI 1.52 to 2.29, p <0.001). Three trials found no benefit from a higher dose of text messages on smoking cessation. Two trials that tested the added benefit of text messaging to pharmacotherapy reported outcomes in favour of adding text messaging.

Conclusions Findings suggest that text messaging-based interventions are effective at promoting smoking cessation. Further research is required to establish if any additional benefit is gained from an increased number of text messages or concurrent pharmacotherapy or behavioural counselling.

  • Cessation
  • Global health
  • Public policy

Data availability statement

Data are available upon request.

https://doi.org/10.1136/tc-2023-058323

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    Data availability statement

    Data are available upon request.

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    Footnotes

    • Twitter @ChenealPuljevic, @kyliemorphett, @CoralGartner

    • Contributors Study conception and design: CEG, CP, KM, DS, GC, CLS and EET. Article screening: CP and IM. Data extraction: CP, IM, AH, DS and EG. Data analysis: HK, GC and CEG. Draft manuscript preparation: CP, CEG, IM, AH, DS, CLS, EET, KM, HK, GC and CEG. Guarantor: CP. All authors reviewed and approved the final version of the manuscript.

    • Funding Funding for this study was provided by the WHO. Funders provided advice on the protocol but played no role in data extraction or interpretation. CP is supported by a Discovery Early Career Researcher Award from the Australian Research Council (DE230101131). CEG is supported by the National Health and Medical Research Council Centre of Research Excellence on Achieving the Tobacco Endgame (NHMRC Grant GNT1198301) and an Australian Research Council Future Fellowship (FT220100186).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.