A Systematic Review of Digital Intervention of Smoking Abstinence During the COVID-19 Era

Abstract

Background and Purpose: The COVID-19 pandemic created unique challenges for smoking cessation efforts. Mobile health (mHealth) interventions like smartphone apps and text messaging represent a promising approach to support quitting during the pandemic, but evidence of their effectiveness in the COVID context has been limited. This systematic review aimed to synthesize evidence on mobile phone-based interventions for smoking cessation during the COVID-19 pandemic, describing study and intervention characteristics and evaluating impacts on smoking abstinence outcomes. Materials and Methods: A systematic literature search of PubMed, MEDLINE, and EMBASE was conducted for experimental studies on mobile phone interventions for smoking cessation published during the COVID-19 pandemic from 2021 to 2023. Study selection and data extraction were performed independently by two reviewers. Eligible studies were described narratively. Results: Six studies with 3,878 total participants met the inclusion criteria. Across the 6 studies, mobile phone interventions generally showed some positive impacts on quit intentions, attempts, and abstinence compared to control groups, but most differences were not statistically significant. Two studies found slight increases in quit intention associated with smoking cessation messaging. One study showed a higher rate of quit attempts in the past 24 hours and 12 months among the intervention group, and two studies showed higher abstinence rates at certain follow-ups in intervention arms, though not reaching significance. Conclusion: Overall, the evidence implies text messaging and mobile apps could confer benefits for cessation, but current research has not definitively confirmed their efficacy. Mobile phone interventions demonstrate preliminary potential to aid smoking cessation during the pandemic, but high-quality randomized controlled trials are needed to firmly establish their efficacy. Advancing mHealth solutions is critical to address elevated tobacco use risks during COVID-19. Key words: COVID-19; Cessation; Digital Health; Intervention; Smoking