Effects of Web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials.

Background The effects of Web- and computer-based smoking cessation programs are inconsistent in randomized controlled trials (RCTs). We evaluated those effects using a meta-analysis. Methods We searched MEDLINE (PubMed), EMBASE, and the Cochrane Review in August 2008. Two evaluators independently selected and reviewed eligible studies. Results Of 287 articles searched, 22 RCTs, which included 29 549 participants with 16 050 enrolled in Web- or computer-based smoking cessation program groups and 13 499 enrolled in control groups, were included in the final analyses. In a random-effects meta-analysis of all 22 trials, the intervention group had a significant effect on smoking cessation (relative risk [RR], 1.44; 95% confidence interval [CI], 1.27-1.64). Similar findings were observed in 9 trials using a Web-based intervention (RR, 1.40; 95% CI, 1.13-1.72) and in 13 trials using a computer-based intervention (RR, 1.48; 95% CI, 1.25-1.76). Subgroup analyses revealed similar findings for different levels of methodological rigor, stand-alone vs supplemental interventions, type of abstinence rates employed, and duration of follow-up period, but not for adolescent populations (RR, 1.08; 95% CI, 0.59-1.98). Conclusion The meta-analysis of RCTs indicates that there is sufficient clinical evidence to support the use of Web- and computer-based smoking cessation programs for adult smokers.