Internet-based tobacco cessation interventions

Internet-based tobacco cessation interventions 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, pharmacotherapy (e.g., nicotine replacement therapy (NRT)), remote counseling, or text messaging (Cochrane-Taylor 2017).

Expected Beneficial Outcomes (Rated)

  • Increased quit rates

Evidence of Effectiveness

There is strong evidence that internet-based tobacco cessation interventions help tobacco users quit (McCrabb 2018*, Graham 2016, Afshin 2016, Park 2015*, Chen 2012, Danaher 2015*, Brown 2014c*). 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 (Cochrane-Taylor 2017, Hutton 2011*) and college students (Cochrane-Taylor 2017, Gulliver 2015, Hutton 2011*); additional research is needed to determine effects for teens (Cochrane-Taylor 2017, Hutton 2011*) and young adults (Cochrane-Fanshawe 2017*).

Internet-based interventions that include text messages (Brown 2013a*), email messages (Hutton 2011*), or a combination of the two (Danielsson 2014*) have been shown to help adults quit smoking (Cochrane-Taylor 2017). Effects have been demonstrated for various populations, including psychiatric patients, individuals receiving inpatient care for substance use disorders, and indigenous populations (Boland 2018*). Interventions that are interactive, tailored to participants’ circumstances, and include automated contact via email or text message can also help adults quit (Cochrane-Taylor 2017).

Internet-based interventions combined with pharmacotherapies such as nicotine replacement therapy (NRT) can increase the likelihood of successful quit attempts (Cochrane-Taylor 2017). Participants better adhere to internet-based cessation programs with NRT (Graham 2017*) or an online supportive social network than programs without these features (Graham 2017*, Papandonatos 2016). Early studies of interventions that use social media platforms such as Twitter and Facebook suggest they can increase quit rates and quit attempts, and reduce relapses (Naslund 2017*).

Research suggests that effective internet-based smoking cessation programs for adolescents (Park 2015*) and adults (Newman 2011*) 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 (Park 2015*, Newman 2011*). 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 (Cochrane-Taylor 2017, Hutton 2011*). Internet-based interventions may be more effective if they include direct interaction between participants and their health care providers (Afshin 2016). Adding internet-based components to counseling may not improve counseling’s effects on quit rates (Cochrane-Taylor 2017, Hutton 2011*).

Internet-based interventions appear to be cost-effective (Chen 2012, Graham 2013*). For example, Tweet2Quit, a cessation program that uses Twitter, has low associated costs (Pechmann 2017*). Additional evidence is needed to determine if internet-based interventions are more cost-effective than quitlines or in-person counseling (Cochrane-Taylor 2017).

Smokers with high levels of education appear more likely than smokers with lower levels of education to use internet-based programs to quit tobacco (Hill 2014b).

Impact on Disparities

Likely to increase disparities

Implementation Examples

The US Department of Health and Human Services (US DHHS) provides several targeted internet-based smoking cessation interventions, including Smokefree Women, Smokefree Teen, Smokefree Vet, Smokefree Español and Smokefree 60+ (; participants can build individualized quit plans and receive support as part of these programs ( Plan). 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 - US Department of Health and Human Services (US DHHS). Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App.

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.

Citations - Evidence

* Journal subscription may be required for access.

McCrabb 2018* - McCrabb S, Baker AL, Attia J, et al. Internet-based programs incorporating behavior change techniques are associated with increased smoking cessation in the general population: A systematic review and meta-analysis. Annals of Behavioral Medicine. 2018;(August):1-16.

Graham 2016 - Graham A, Carpenter K, Cha S, et al. Systematic review and meta-analysis of Internet interventions for smoking cessation among adults. Substance Abuse and Rehabilitation. 2016:55-69.

Afshin 2016 - Afshin A, Babalola D, Mclean M, et al. Information technology and lifestyle: A systematic evaluation of internet and mobile interventions for improving diet, physical activity, obesity, tobacco, and alcohol use. Journal of the American Heart Association. 2016;5(9).

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.

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.

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.

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.

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

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.

Cochrane-Fanshawe 2017* - Fanshawe TR, Halliwell W, Lindson N, Aveyard P. Tobacco cessation interventions for young people. Cochrane Database of Systematic Reviews. 2017;(11).

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.

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.

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.

Graham 2017* - 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. 2017;19(3):324–332.

Papandonatos 2016 - Papandonatos GD, Erar B, Stanton CA G AL. Online community use predicts abstinence in combined internet/phone intervention for smoking cessation. Journal of Consulting and Clinical Psychology. 2016;84(7):633-644.

Naslund 2017* - Naslund JA, Kim SJ, Aschbrenner KA, et al. Systematic review of social media interventions for smoking cessation. Addictive Behaviors. 2017;73:81-93.

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 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.

Pechmann 2017* - Pechmann C, Delucchi K, Lakon CM, Prochaska JJ. Randomised controlled trial evaluation of tweet2quit: A social network quit-smoking intervention. Tobacco Control. 2017;26(2):188-194.

Hill 2014b - Hill S, Amos A, Clifford D, Platt S. Impact of tobacco control interventions on socioeconomic inequalities in smoking: Review of the evidence. Tobacco Control. 2014;23:e89-e97

Citations - Implementation Examples

* Journal subscription may be required for access. - US Department of Health and Human Services (US DHHS). Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App. Plan - US Department of Health and Human Services (US DHHS). Create My Quit Plan. 2018.

QuitNet - QuitNet. Don't quit alone.

Stop Smoking Center - Stop Smoking Center.

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