Internet-based tobacco cessation interventions

Internet-based tobacco cessation interventions typically provide information, strategies, or behavioral support to assist tobacco users who want to quit (CG-Tobacco use). Such interventions include websites, computer programs, or other electronic aids (Chen 2012). Interventions may rely solely on internet technology or include components such as in-person counseling, remote counseling, text messaging, or pharmacotherapy (e.g., nicotine replacement therapy (NRT)) (). 

Expected Beneficial Outcomes (Rated)

  • Increased quit rates

Evidence of Effectiveness

There is strong evidence that internet-based tobacco cessation interventions help tobacco users quit (, Chen 2012, , ). Interventions for individuals who are cessation-ready and those who have not yet decided to quit both appear effective (Chen 2012). Interventions are effective for adults (, ) and college students (, Gulliver 2015, ); additional research is needed to determine effects for teens (, ).

Internet-based interventions that include text messages (), e-mail messages (), or a combination of the two () have been shown to help adults quit smoking. Interventions that are interactive, tailored to participants’ circumstances, and include automated phone contacts can also help adults quit ().

Internet-based interventions combined with pharmacotherapies such as nicotine replacement therapy (NRT) can increase the likelihood of successful quit attempts (). Participants better adhere to internet-based cessation programs with NRT or an online supportive social network than programs without these features (). Additional research is needed to determine the effectiveness of cessation programs that use Twitter (Pechmann 2015), Facebook (), and other forms of social media (Pechmann 2015).

Research suggests that effective internet-based smoking cessation programs for adolescents () and adults () usually include combinations of multimedia and interactive features (e.g., videos or stories), content that is tailored to participants’ demographic characteristics, or feedback that reflects participants’ progress and goals (, ). Some studies suggest that websites that are interactive or tailored to participants’ demographic characteristics are more effective than sites that are static or more general; other studies suggest equal effects (, ). Adding internet-based components to counseling may not improve counseling’s effects on quit rates (, ).   

Internet-based interventions appear to be cost-effective (Chen 2012, ). Additional evidence is needed to determine if internet-based interventions are more cost-effective than quitlines or in-person counseling ().

Smokers who are highly educated appear more likely than smokers with less education to use internet-based programs to quit tobacco (Hill 2013a). 

Impact on Disparities

Likely to increase disparities

Implementation Examples

The US Department of Health and Human Services provides several targeted internet-based smoking cessation interventions which include Smokefree Women, Smokefree Teen, Smokefree Vet, Smokefree Espanol, and Smokefree 60+ (Smokefree.gov). Many other websites offer online cessation programs to help individuals stop smoking. Examples of such sites include QuitNet and Stop Smoking Center (QuitNet, Stop Smoking Center).  

Implementation Resources

Smokefree.gov - Smokefee.gov. It doesn't matter where you start. Just start.

ALA-FFS Online - American Lung Association (ALA). Freedom from smoking online.

WebMD-Smoking cessation - WebMD. Smoking cessation health center.

EX - EX. Become an Ex. A new way to think about quitting smoking.

QSC - Quit Smoking Community (QSC).

Smokefree.gov - US Department of Health and Human Services (US DHHS). Smokefree.gov. Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App.

Citations - Evidence

* Journal subscription may be required for access.

Cochrane-Civljak 2013* - Civljak M, Stead LF, Hartmann-Boyce J, Sheikh A, Car J. Internet-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2013;(7):CD007078.

Chen 2012 - Chen Y, Madan J, Welton N, et al. Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: A systematic review and network meta-analysis. Health Technology Assessment (Winchester, England). 2012;16(38):1–205, iii–v.

Graham 2013* - Graham AL, Chang Y, Fang Y, et al. Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of The iQUITT Study. Tobacco Control. 2013;22(6):e11.

Hill 2013a - Hill S, Amos A, Clifford D, Platt S. Impact of tobacco control interventions on socioeconomic inequalities in smoking: Review of the evidence. Tobacco Control. 2013;0:1–9.

Brown 2013a* - Brown J. A review of the evidence on technology-based interventions for the treatment of tobacco dependence in college health. Worldviews on Evidence-Based Nursing. 2013;10(3):150–62.

Hutton 2011* - Hutton HE, Wilson LM, Apelberg BJ, et al. A systematic review of randomized controlled trials: Web-based interventions for smoking cessation among adolescents, college students, and adults. Nicotine & Tobacco Research. 2011;13(4):227–38.

Gulliver 2015 - Gulliver A, Farrer L, Chan J, et al. Technology-based interventions for tobacco and other drug use in university and college students: A systematic review and meta-analysis. Addiction Science & Clinical Practice. 2015;10(1):5.

Pechmann 2015 - Pechmann C, Pan L, Delucchi K, Lakon CM, Prochaska JJ. Development of a Twitter-based intervention for smoking cessation that encourages high-quality social media interactions via automessages. Journal of Medical Internet Research. 2015;17(2):e50.

Brown 2014c* - Brown J, Michie S, Geraghty AWA, et al. Internet-based intervention for smoking cessation (StopAdvisor) in people with low and high socioeconomic status: A randomised controlled trial. The Lancet Respiratory Medicine. 2014;2(12):997-1006.

Danaher 2015* - Danaher BG, Severson HH, Crowley R, et al. Randomized controlled trial examining the adjunctive use of nicotine lozenges with MyLastDip: An eHealth smokeless tobacco cessation intervention. Internet Interventions. 2015;2(1):69-76.

Danielsson 2014* - Danielsson AK, Eriksson AK, Allebeck P. Technology-based support via telephone or web: A systematic review of the effects on smoking, alcohol use and gambling. Addictive Behaviors. 2014;39(12):1846-1868.

Park 2015* - Park E, Drake E. Systematic review: Internet-based program for youth smoking prevention and cessation. Journal of Nursing Scholarship. 2015;47(1):43-50.

Newman 2011* - Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy? Clinical Psychology Review. 2011;31(1):178-186.

Graham 2016* - Graham AL, Papandonatos GD, Cha S, et al. Improving adherence to smoking cessation treatment: Intervention effects in a web-based randomized trial. Nicotine & Tobacco Research. 2016.

Cobb 2016* - Cobb NK, Jacobs MA, Wileyto P, Valente T, Graham AL. Diffusion of an evidence-based smoking cessation intervention through Facebook: A randomized controlled trial. American Journal of Public Health. 2016;106(6):1130-1135.

Citations - Implementation Examples

* Journal subscription may be required for access.

Stop Smoking Center - Stop Smoking Center.

QuitNet - QuitNet. Don't quit alone.

Smokefree.gov - Smokefee.gov. It doesn't matter where you start. Just start.

Smokefree.gov - US Department of Health and Human Services (US DHHS). Smokefree.gov. Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App.

Date Last Updated

Dec 20, 2016