title: The Methodological Quality and Effectiveness of Technology-Based Smoking Cessation Interventions for Disadvantaged Groups: A Systematic Review and Meta-analysis.
abstract: To assess the methodological quality and effectiveness of technology-based smoking cessation interventions in disadvantaged groups.
  
  
  
  Four databases (EMBASE, Cochrane, Medline, and PsycInfo) were searched for studies conducted from 1980 to May 2016. Randomized controlled trials that compared a behavioral smoking cessation intervention delivered primarily through a technology-based platform (eg, mobile phone) with a no-intervention comparison group among disadvantaged smokers were included. Three reviewers assessed all relevant studies for inclusion, and one reviewer extracted study, participant and intervention-level data, with a subset crosschecked by a second reviewer.
  
  
  
  Thirteen studies targeting disadvantaged smokers (n =4820) were included. Only one study scored highly in terms of methodological rigor on EPOC criteria for judging risk of bias. Of the 13 studies using a technology-based platform, most utilized websites (n = 5) or computer programs (n = 5), and seven additionally offered nicotine replacement therapy. Technology-based interventions increased the odds of smoking cessation for disadvantaged groups at 1 month (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.10, 2.63), 3 months (OR 1.30, 95% CI 1.07, 1.59), 6 months (OR 1.29, 95% CI 1.03, 1.62), and 18 months post-intervention (OR 1.83, 95% CI 1.11, 3.01).
  
  
  
  Few methodologically rigorous studies were identified. Mobile phone text-messaging, computer- and website-delivered quit support showed promise at increasing quit rates among Indigenous, psychiatric and inpatient substance use disorder patients. Further research is needed to address the role technology-based interventions have on overcoming health inequalities to meet the needs of disadvantaged groups.
  
  
  
  This review provides the first quantitative evidence of the effectiveness of a range of technology-based smoking cessation interventions among disadvantaged smokers, with separate estimates on the basis of intervention type, and cessation outcome measure. Providing cost-effective, easily accessible and real-time smoking cessation treatment is needed, and innovative technology-based platforms will help reach this endpoint. These interventions need to be tested in larger scale randomized controlled trial designs and target broader disadvantaged groups. Data collection beyond 6 months is also needed in order to establish the efficacy of these intervention approaches on long-term cessation rates among disadvantaged population groups.
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia.
authors.forename: Veronica C
authors.initials: VC
authors.lastname: Boland
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Stockings
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Mattick
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
authors.forename: Hayden
authors.initials: H
authors.lastname: McRobbie
authors.affiliation: Department of Clinical, Educational and Health Psychology, University College London, London, UK.
authors.forename: Jamie
authors.initials: J
authors.lastname: Brown
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), University of New South Wales (UNSW), Randwick, Australia.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Courtney
mesh_terms: D040421:Cell Phone / Q000191:economics; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D000074285:Smokers / Q000523:psychology; D016540:Smoking Cessation / Q000191:economics / Q000379:methods* / Q000523:psychology*; D012984:Software / Q000191:economics; D060145:Text Messaging / Q000191:economics; D013813:Therapy, Computer-Assisted / Q000191:economics / Q000379:methods*; D061485:Tobacco Use Cessation Devices / Q000191:economics; D016896:Treatment Outcome; D035862:Vulnerable Populations / Q000523:psychology*