Cell phone-based tobacco cessation interventions

Cell phone-based tobacco cessation interventions generally include cessation advice, motivational messages, or content to distract from cravings and can be delivered via text, smartphone applications (apps), or video messages. Messages may be tailored to participant characteristics (e.g., gender, age, ethnicity) or personalized to individual participants. Messages may be sent automatically or sent based on participants’ needs. Some interventions include interactive features or connect participants to each other virtually for additional support (Cochrane-Whittaker 2016*, Scott-Sheldon 2016*).

Note: The term “tobacco” in this strategy refers to commercial tobacco, not ceremonial or traditional tobacco. County Health Rankings & Roadmaps recognizes the important role that ceremonial and traditional tobacco play for many Tribal Nations, and our tobacco-related work focuses on eliminating the harms and inequities associated with commercial tobacco.

Expected Beneficial Outcomes (Rated)

  • Increased quit rates

Evidence of Effectiveness

There is strong evidence that cell phone-based tobacco cessation interventions help smokers quit smoking long-term (Cochrane-Whittaker 2016*, Spohr 2015*, Scott-Sheldon 2016*, Ybarra 2016*, West 2015, Poorman 2015). Interventions that use spoken messages, text messages, or combinations of cell phone and internet-based components have been shown to help smokers quit, though effectiveness varies by intervention (CG-Tobacco use, Palmer 2018, Cochrane-Taylor 2017, Spohr 2015*, Abroms 2014*).

Interventions that send text messages and include web or in-person elements are slightly more effective than text-only interventions. Sending text messages on a fixed schedule may increase cessation more than sending a decreasing or variable number of texts (Spohr 2015*). Evaluations of Text2Quit suggest pairing cell phone-based interventions with quitlines may increase quit rates (Abroms 2014*), possibly by increasing smokers’ confidence in their ability to quit (Hoeppner 2017*), and Quit4baby may reduce smoking by pregnant women (Abroms 2017*). Text messaged-based interventions that include social support may reduce tobacco use, increase intentions not to smoke, and increase social support from peers for black adolescents in urban areas (Mason 2016a, Mason 2015a).

When used with text message-based cessation interventions, smartphone applications (apps) can support quitting (Buller 2014). However, additional evidence is needed to confirm effects of smartphone apps alone (Riaz 2015*, Cochrane-Whittaker 2016*, Coughlin 2016); many commercially available cessation smartphone apps have not been tested for effectiveness (Haskins 2017*).

Cell phone and text message-based interventions have demonstrated positive effects for various populations, including psychiatric patients, individuals receiving inpatient care for substance use disorders, and indigenous populations (Boland 2018*). Cell phone-based tobacco cessation interventions, particularly text message interventions, are cost-effective (Cochrane-Whittaker 2016*, Ybarra 2016*, Spohr 2015*) and can be scaled to serve large populations (Cochrane-Whittaker 2016*).

Impact on Disparities

No impact on disparities likely

Implementation Examples

Text2Quit, an automated, personalized, text message-based cessation intervention that offers advice, support, and reminders along with a personalized web portal and email follow-up (Text2Quit), and StopMySmoking, a young adult-focused intervention that offers 24/7 craving support through on-demand assistance, message-timing control, and optional pairing with a quit buddy (StopMySmoking), are two examples of cell phone-based interventions.

The US Department of Health and Human Services (US DHHS) also provides several targeted text message-based smoking cessation interventions, including SmokefreeMOM, Smokefree Teen, Smokefree Vet, Smokefree Español, and Smokefree VET en Español (SmokeFreeTXT), along with two Smokefree smartphone apps, QuitGuide and QuitSTART (Smokefree.gov Apps).

Implementation Resources

SmokeFreeTXT - US Department of Health and Human Services (US DHHS). Smokefree.gov. SmokeFree text messaging programs: SmokefreeTXT, Smokefree VET, SmokefreeMOM, Smokefree Teen, Smokefree Espanol, and SmokefreeVET en Espanol.

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.

Smokefree.gov-Health care professionals - US Department of Health and Human Services (US DHHS). Smokefree.gov. Resources for health care professionals.

Citations - Evidence

* Journal subscription may be required for access.

Cochrane-Whittaker 2016* - Whittaker R, McRobbie H, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2016;(4):CD006611.

Spohr 2015* - Spohr SA, Nandy R, Gandhiraj D, Vemulapalli A, Anne S, Walters ST. Efficacy of SMS text message interventions for smoking cessation: A meta-analysis. Journal of Substance Abuse Treatment. 2015;56:1-10.

Scott-Sheldon 2016* - Scott-Sheldon LAJ, Lantini R, Jennings EG, et al. Text messaging-based interventions for smoking cessation: A systematic review and meta-analysis. JMIR mHealth and uHealth. 2016;4(2):e49.

Ybarra 2016* - Ybarra ML, Jiang Y, Free C, Abroms LC, Whittaker R. Participant-level meta-analysis of mobile phone-based interventions for smoking cessation across different countries. Preventive Medicine. 2016;89:90-97.

West 2015 - West R, Raw M, McNeill A, et al. Health-care interventions to promote and assist tobacco cessation: A review of efficacy, effectiveness and affordability for use in national guideline development. Addiction. 2015;110(9):1388-1403.

Poorman 2015 - Poorman E, Gazmararian J, Parker RM, Yang B, Elon L. Use of text messaging for maternal and infant health: A systematic review of the literature. Maternal and Child Health Journal. 2015;19(5):969-989.

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco.

Palmer 2018 - Palmer M, Sutherland J, Barnard S, et al. The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomized controlled trials. PLOS ONE. 2018;13(1):e0189801.

Cochrane-Taylor 2017 - Taylor GMJ, Dalili MN, Semwal M, et al. Internet-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2017;(9):CD007078.

Abroms 2014* - Abroms LC, Boal AL, Simmens SJ, Mendel JA, Windsor RA. A randomized trial of Text2Quit: A text messaging program for smoking cessation. American Journal of Preventive Medicine. 2014;47(3):242-250.

Hoeppner 2017* - Hoeppner BB, Hoeppner SS, Abroms LC. How do text-messaging smoking cessation interventions confer benefit? A multiple mediation analysis of Text2Quit. Addiction. 2017;112(4):673-682.

Abroms 2017* - Abroms LC, Johnson PR, Leavitt LE, et al. A randomized trial of text messaging for smoking cessation in pregnant women. American Journal of Preventive Medicine. 2017;53(6):781-790.

Mason 2016a - Mason M, Mennis J, Way T, et al. Text message delivered peer network counseling for adolescent smokers: A randomized controlled trial. Journal of Primary Prevention. 2016;37(5):403-420.

Mason 2015a - Mason M, Ola B, Zaharakis N, Zhang J. Text messaging interventions for adolescent and young adult substance use: A meta-analysis. Prevention Science. 2015;16(2):181-188.

Buller 2014 - Buller DB, Borland R, Bettinghaus EP, Shane JH, Zimmerman DE. Randomized trial of a smartphone mobile application compared to text messaging to support smoking cessation. Telemedicine Journal and E-Health. 2014;20(3):206-214.

Riaz 2015* - Riaz S, Sykes C. Are smartphone health applications effective in modifying obesity and smoking behaviours? A systematic review. Health and Technology. 2015;5(2):73-81.

Coughlin 2016 - Coughlin S, Thind H, Liu B, et al. Mobile phone apps for preventing cancer through educational and behavioral interventions: State of the art and remaining challenges. JMIR mHealth and uHealth. 2016;4(2):e69.

Haskins 2017* - Haskins BL, Lesperance D, Gibbons P, Boudreaux ED. A systematic review of smartphone applications for smoking cessation. Translational Behavioral Medicine. 2017;7(2):292-299.

Boland 2018* - Boland VC, Stockings EA, Mattick RP, McRobbie H, Brown J, Courtney RJ. The methodological quality and effectiveness of technology-based smoking cessation interventions for disadvantaged groups: A systematic review and meta-analysis. Nicotine & Tobacco Research. 2018;20(3):276–285.

Citations - Implementation Examples

* Journal subscription may be required for access.

Text2Quit - Text2Quit. Customized help to quit smoking with text messaging-based support.

StopMySmoking - StopMySmoking. Quit smoking in six weeks with daily text messages designed for young adults. Center for Innovative Public Health Research.

SmokeFreeTXT - US Department of Health and Human Services (US DHHS). Smokefree.gov. SmokeFree text messaging programs: SmokefreeTXT, Smokefree VET, SmokefreeMOM, Smokefree Teen, Smokefree Espanol, and SmokefreeVET en Espanol.

Smokefree.gov Apps - US Department of Health and Human Services (US DHHS). Smokefree.gov. Smokefree Apps: QuitGuide and QuitSTART.

Date Last Updated