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Tobacco Use and Secondhand Smoke Exposure: Internet-Based Cessation Interventions


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review published in 2010 (Civljak et al., search period through June 2010) combined with more recent evidence (search period June 2010-August 2011).

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to reducing tobacco use and secondhand smoke exposure.


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Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement pdf icon [PDF - 165 kB].

The systematic review included 24 studies.

Thirteen of the included studies compared internet-based interventions with either usual care or non-Internet-based interventions.

  • Results across studies were inconsistent.
  • Studies that targeted adult tobacco users showed cessation increased by a median of 3.2 percentage points (7 studies).

Eleven of the included studies compared different types of internet-based interventions and found inconsistent results.

Ten of the included studies compared internet-based interventions that provided tailored and interactive content with non-tailored-internet or no-internet interventions.

  • Results across studies were inconsistent.
  • Studies reported cessation increased by a median of 2.1 percentage points.

Summary of Economic Evidence

An economic review included five studies. There were so many differences between the interventions, however, that results could not be combined.


Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base.

  • How would the development and use of more recent technologies change outcomes?
  • How can programs increase the number of users who enroll and use the intervention?
  • What is the economic efficiency of Internet-based cessation interventions and the recruiting process involved?
  • How do effectiveness rates vary by demographic characteristics?

Study Characteristics

  • Studies were conducted in the United States, Norway, the United Kingdom, Germany, Switzerland, New Zealand, and the Netherlands.
  • Three studies targeted adolescents and two studies targeted young adults.
  • Included studies used trial designs with concurrent comparisons, but many of the comparisons and analyses were not directly relevant.
  • Studies often provided one or more interventions to participants in the comparison group; seven studies provided evidence-based treatments such as cessation counseling or medications.
  • The observed rates of loss to follow-up were high in many of the included studies (median 36.7%).