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Abstract
To examine the efficacy and acceptability of online, interactive interventions for
smoking cessation and to identify treatment effect moderators and mediators.
A systematic review and meta-analysis of the literature (1990-2008) was conducted,
finding 11 relevant randomized controlled trials. Data were extracted and risk ratios
and risk differences estimated with a random effects model.
There was no evidence of publication bias. Included trials were of variable methodological
quality. Web-based, tailored, interactive smoking cessation interventions were effective
compared with untailored booklet or e-mail interventions [rate ratio (RR) 1.8; 95%
confidence interval (CI) 1.4-2.3] increasing 6-month abstinence by 17% (95% CI 12-21%).
No overall effect of interactive compared with static web-based interventions was
detected but there was significant heterogeneity, with one study obtaining a clear
effect and another failing to find one. Few moderating or mediating factors were evaluated
in studies and those that were had little effect. Pooled results suggest that only
interventions aimed at smokers motivated to quit were effective (RR 1.3, 95% CI 1.0-1.7).
Fully automated interventions increased smoking cessation rates (RR 1.4, 95% CI 1.0-2.0),
but evidence was less clear-cut for non-automated interventions. Overall, the web-based
interventions evaluated were considered to be acceptable and user satisfaction was
generally high.
Interactive, web-based interventions for smoking cessation can be effective in aiding
cessation. More research is needed to evaluate the relative efficacy of interactive
web-based interventions compared with static websites.