title: A systematic review of randomized controlled trials: Web-based interventions for smoking cessation among adolescents, college students, and adults.
abstract: BACKGROUND
  Web-based treatments can deliver broad reaching, relatively inexpensive, and clinically tested methods for smoking cessation. We performed a systematic review of randomized controlled trials (RCTs) of smoking cessation to evaluate the efficacy of Web-based interventions in adults, college students, and adolescents.
  
  
  METHODS
  MEDLINE, EMBASE, The Cochrane Library, CINAHL, and PsycINFO were searched from January 1, 1990 through February 12, 2010 for RCTs examining the efficacy of Web-based smoking cessation programs. Paired reviewers abstracted data on study design, patient characteristics, and outcomes sequentially and did quality assessments independently.
  
  
  RESULTS
  Twenty-one RCTs met eligibility criteria, with 15 conducted among adults. Among adults, 2 RCTs found that a multicomponent intervention with Web and non-Web-based elements was more efficacious than a self-help manual, and one of 2 RCTs found that Web-based interventions may be more effective than no treatment. Three trials provided insufficient evidence to demonstrate whether Web-based interventions were more efficacious than counseling. By contrast, tailored Web sites in 2 RCTs and greater Web site exposure in 6 of 7 RCTs were associated with higher rates of abstinence. Among college students, evidence supporting use of Web-based interventions was insufficient because the one RCT conducted was also a multicomponent intervention. Five RCTs among adolescents demonstrated mixed results, with insufficient evidence supporting their efficacy.
  
  
  CONCLUSIONS
  Evidence supporting the use of Web-based interventions for smoking cessation is insufficient to moderate in adults and insufficient in college students and adolescents. These RCTs have, however, elucidated clinical, methodological, and statistical practices that are likely to improve future trial design and treatment delivery.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD 21287, USA. hhutton@jhmi.edu
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Hutton
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Wilson
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Apelberg
authors.forename: Erika Avila
authors.initials: EA
authors.lastname: Tang
authors.forename: Olaide
authors.initials: O
authors.lastname: Odelola
authors.forename: Eric B
authors.initials: EB
authors.lastname: Bass
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Chander
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D020407:Internet; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods / Q000706:statistics & numerical data; D012907:Smoking / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D013334:Students / Q000706:statistics & numerical data; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult