Cochrane for Clinicians

Putting Evidence into Practice

Smoking Cessation with Text Messaging and App-Based Interventions


Am Fam Physician. 2020 Aug 1;102(3):148-149.

Author disclosure: No relevant financial affiliations.

Clinical Question

Do cell phone–based smoking cessation interventions increase cessation rates in people who smoke?

Evidence-Based Answer

Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%). (Strength of Recommendation [SOR]: A, based on consistent, good-quality patient-oriented evidence.) Adding text messaging to other smoking cessation interventions is more effective than other smoking cessation interventions alone (ARR = 4%; 95% CI, 1% to 10%). (SOR: A, based on consistent, good-quality patient-oriented evidence.) When smartphone smoking cessation apps are compared with lower intensity smoking cessation support, such as printed educational materials, they have not been shown to increase the likelihood of smoking cessation.1 (SOR: C, based on consensus, disease-oriented evidence, usual practice, expert opinion, or case series.)

Practice Pointers

In 2015, 68% of adults in the United States who smoked cigarettes reported they wanted to quit completely.2 Cell phone interventions such as text messaging and smartphone apps are being explored as options to support smoking cessation. The potential benefits of cell phone interventions include the ease of use, cost-effective delivery and scalability to large populations, the ability to individualize and send time-sensitive messages, the opportunity to provide content that can distract from cravings, and the ability to provide social support.1

This Cochrane review included 26 randomized controlled trials (RCTs; N = 33,849) that compared quit rates among individuals who received text messages or smartphone app interventions vs. either a lower intensity intervention (less frequent messaging) or alternate educational interventions (such as printed cessation materials or general health information).1 The settings, recruitment methods, and control interventions varied considerably across studies. Study settings included the United States,

Author disclosure: No relevant financial affiliations.


1. Whittaker R, McRobbie H, Bullen C, et al. Mobile phone text messaging and app-based interventions for smoking cessation. Cochrane Database Syst Rev. 2019;(10):CD006611.

2. Babb S, Malarcher A, Schauer G, et al. Quitting smoking among adults–United States, 2000–2015. MMWR Morb Mortal Wkly Rep. 2017;65(52):1457–1464.

3. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. U.S. Department of Health and Human Services. Public Health Service; May 2008.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at



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