Systematic review and meta-analysis of Internet interventions for smoking cessation among adults.

IF 5.1 Q1 SUBSTANCE ABUSE Substance Abuse and Rehabilitation Pub Date : 2016-05-18 eCollection Date: 2016-01-01 DOI:10.2147/SAR.S101660
Amanda L Graham, Kelly M Carpenter, Sarah Cha, Sam Cole, Megan A Jacobs, Margaret Raskob, Heather Cole-Lewis
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Abstract

Background: The aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines.

Methods: This review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of "Internet," "web-based," and "smoking cessation intervention" and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs) for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results: Forty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15-2.21, I (2)=51.7%; four studies). Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63-1.10, I (2)=0%; two studies), whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25-3.52, I (2)=41.6%; two studies). No significant effects were observed in pooled results of Internet interventions compared to face-to-face counseling (RR 1.35, 95% CI 0.97-1.87, I (2)=0%; four studies) or to telephone counseling (RR 0.95, 95% CI 0.79-1.13, I (2)=0%; two studies). The majority of trials compared different Internet interventions; pooled results from 15 such trials (24 comparisons) found a significant effect in favor of experimental Internet interventions (RR 1.16, 95% CI 1.03-1.31, I (2)=76.7%).

Conclusion: Internet interventions are superior to other broad reach cessation interventions (ie, print materials), equivalent to other currently recommended treatment modes (telephone and in-person counseling), and they have an important role to play in the arsenal of tobacco-dependence treatments.

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成人戒烟互联网干预的系统回顾和荟萃分析。
背景本系统综述旨在确定相对于治疗指南推荐的其他干预形式,互联网干预在促进成年烟草使用者戒烟方面的有效性:本综述遵循 Cochrane 协作组织系统综述指南。在自动搜索和人工搜索中使用了 "互联网"、"基于网络 "和 "戒烟干预 "以及相关关键词的组合。我们纳入了从 1990 年 1 月到 2015 年 4 月发表的随机试验。我们使用了修改版的 Cochrane 偏倚风险评估工具。我们计算了每项研究的风险比 (RR)。采用随机效应法进行 Meta 分析,以汇总 RRs。结果的表述遵循 PRISMA(系统综述和 Meta 分析首选报告项目)指南:共纳入 40 项随机试验,涉及 98530 名参与者。大多数试验在大多数领域的偏倚风险较低。互联网干预与仅评估/等待清单对照的汇总结果差异显著(RR 1.60,95% 置信区间 [CI] 1.15-2.21,I (2)=51.7%; 四项研究)。与印刷材料相比,基本静态的互联网干预的汇总结果不显著(RR 0.83,95% CI 0.63-1.10,I (2)=0%;两项研究),而与印刷材料相比,交互式互联网干预的汇总结果显著(RR 2.10,95% CI 1.25-3.52,I (2)=41.6%;两项研究)。在互联网干预与面对面咨询(RR 1.35,95% CI 0.97-1.87,I (2)=0%;4 项研究)或电话咨询(RR 0.95,95% CI 0.79-1.13,I (2)=0%;2 项研究)的汇总结果中,没有观察到明显的效果。大多数试验对不同的互联网干预措施进行了比较;15 项此类试验(24 项比较)的汇总结果显示,实验性互联网干预措施的效果显著(RR 1.16,95% CI 1.03-1.31,I(2)=76.7%):互联网干预优于其他覆盖面广的戒烟干预(即印刷材料),与目前推荐的其他治疗模式(电话和面对面咨询)相当,在烟草依赖治疗方法中具有重要作用。
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审稿时长
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