Impact of Digital-based Intervention on Smoking Abstinence and Cessation among Adolescents: A Systematic Review

Abstract

Introduction: Adolescent smoking remains a significant public health concern, with digital-based interventions emerging as a potentially effective approach for cessation support in this technologically engaged population. However, their effectiveness specifically among adolescents requires systematic evaluation. This study objective was to assess the effectiveness of digital-based interventions for smoking cessation among adolescents (aged 13–19 years) and identify key factors influencing intervention success. Methods: A systematic review following Preferred Items for Systematic Reviews and Meta-analyses guidelines was conducted across five electronic databases (MEDLINE, Scopus, CINAHL, Cochrane Library, and Web of Science) from inception through December 2024. Studies evaluating digital interventions for adolescent smoking cessation were included. Four independent reviewers conducted study selection and data extraction. Study quality was assessed using the Cochrane Risk of Bias (RoB) tool and RoB in Non-randomized Studies of Interventions. Narrative synthesis was performed due to substantial methodological and clinical heterogeneity across included studies, with structured categorization by intervention type, outcome measurement approaches, and follow-up duration. Results: Analysis of 40 studies (28 randomized controlled trials, 12 nonrandomized studies) revealed cessation rates varying from 6.9% to 65.9%. Age-appropriate integrated digital approaches demonstrated superior outcomes compared to single-component interventions. Social media-based platforms showed promise for adolescent engagement, though effectiveness was moderated by cultural adaptation and implementation strategies. Program engagement emerged as crucial, with higher engagement rates correlating with improved outcomes. Conclusion: Digital-based interventions show promise for adolescent smoking cessation when properly adapted to developmental needs and technological preferences. Success depends on age-appropriate design, cultural relevance, and sustained engagement strategies. Future research should prioritize standardized evaluation metrics for adolescent populations.