Mobile phone services help smokers quit

Text messages are already used by health services to send appointment reminders and to encourage people to stick to treatment programmes. Mobile phones may offer a low cost solution for delivering smoking cessation services. However, an earlier systematic review by Cochrane researchers published in 2009 identified only two trials for mobile phone-based programmes and did not find a long-term improvement in quit rates.

The new review incorporates data from three additional studies and comes to a different conclusion. In total, the researchers analysed results from five studies in which over 9,000 people trying to quit smoking received either motivational messages and quitting advice up to several times a day or control. Some studies incorporated interactive elements, such as polls, and provided extra messages on request to help beat cravings. In one study, participants were sent links to short video diary clips following a role model's attempts to quit smoking, with the aim of promoting some of their strategies. Those in control groups received text messages less frequently, or were given online information or support over the phone.

There was some variation between the study results but the larger, more recent studies showed larger improvements in quit rates after six months. Overall, the researchers estimated that mobile phone programmes could nearly double the chance of quitting for at least six months from 4-5% in control groups to between 6-10% in intervention groups.

"Mobile phone programmes appear to be a useful option to offer those who want to stop smoking," said lead researcher, Robyn Whittaker of the National Institute for Health Innovation at the University of Auckland in Auckland, New Zealand. "The largest trial that we included in our review, which involved 5,800 people in the UK, can be considered definitive. At the very least it shows the efficacy of a mobile phone intervention in a developed country with good tobacco control policy. However, we cannot say that all text messaging interventions will be effective in all contexts."

Currently, no published evidence exists for the cost-effectiveness of smoking cessation services delivered by text message. However, the authors suggest cost savings are likely. "If, as it appears from our review, we can help as many people quit smoking at lower costs than running telephone support lines, then mobile phone-based services must be cost-effective," said Whittaker.

The authors believe further evidence will emerge from another seven long-term trials that are currently underway. At this stage, none of these trials have considered smartphones, but the authors suggest that research on the potential benefits of smartphone applications is also warranted as the effects may be quite different.