A systematic review of digital interventions for smoking cessation in patients with serious mental illness
Open accessAbstract
Tobacco smoking is highly prevalent among patients with serious mental illness (SMI), with known deleterious consequences. Smoking cessation is therefore a prioritary public health challenge in SMI. In recent years, several smoking cessation digital interventions have been developed for non-clinical populations. However, their impact in patients with SMI remains uncertain. We conducted a systematic review to describe and evaluate effectiveness, acceptability, adherence, usability and safety of digital interventions for smoking cessation in patients with SMI. PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, PsychINFO and the Cochrane Tobacco Addiction Group Specialized Register were searched. Studies matching inclusion criteria were included and their information systematically extracted by independent investigators. Thirteen articles were included, which reported data on nine different digital interventions. Intervention theoretical approaches ranged from mobile contingency management to mindfulness. Outcome measures varied widely between studies. The highest abstinence rates were found for mSMART MIND (7-day point-prevalent abstinence: 16–40%). Let's Talk About Quitting Smoking reported greater acceptability ratings, although this was not evaluated with standardized measures. Regarding usability, Learn to Quit showed the highest System Usability Scale scores [mean (s.d.) 85.2 (15.5)]. Adverse events were rare and not systematically reported. Overall, the quality of the studies was fair to good. Digitally delivered health interventions for smoking cessation show promise for improving outcomes for patients with SMI, but lack of availability remains a concern. Larger trials with harmonized assessment measures are needed to generate more definitive evidence and specific recommendations.
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Presently, there is limited evidence for the efficacy of smartphone apps delivering behavioral smoking cessation interventions for individuals with mental health disorders; most studies have been limited to small pilot RCTs and single-arm studies.
“Presently, there is limited evidence for the efficacy of smartphone apps delivering behavioral smoking cessation interventions for individuals with mental health disorders. Most studies have been limited to small pilot randomized controlled trials (RCTs) and single-arm studies [43, 44, 45, 46, 47].”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [46]
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Firth, J., Sawyer, C. S., Sainsbury, J., Morell, R., Fibbins, H., Bucci, S., Hassan, L., Firth, J. A., Onyweaka, H., Torous, J. B., et al. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.116187 · Cited by 7 · see citing works
Self-citationGuinart, D., Fagiolini, A., Fusar-Poli, P., Giordano, G., Leucht, S., Moreno, C., & Correll, C. (2024) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s456163 · Cited by 7 · see citing works
Self-citationSpirito, F. D., Palo, M. P. D., Garofano, M., Sorbo, R. D., Allegretti, G., Rizki, I., Bartolomeo, M. D., Giordano, M., Amato, M., & Bramanti, A. (2025) · Healthcare · doi:10.3390/healthcare13080953 · Cited by 7 · see citing works
Digital interventions in smoking cessation: a brief overview of systematic reviews and meta-analyses
Gliwska, E., & Mańczuk, M. (2024) · Nowotwory Journal of Oncology · doi:10.5603/njo.98341 · Cited by 7 · see citing works
Huddlestone, L., Shoesmith, E., Pervin, J., Stevens, R., Gilbody, S. M., & Ratschen, E. (2024) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntae237 · Cited by 4 · see citing works
Zvolensky, M. J., Brown, R. A., Shepherd, J. M., Brown, J. T., Redmond, B. Y., & Alcocer, S. (2025) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2025.209632 · Cited by 3 · see citing works
Effectiveness of Digital Intervention for Tobacco Cessation Among Adults: A Systematic Review
Wasnik, M., Dave, B. H., & Vadher, V. (2025) · Addiction and Health · doi:10.34172/ahj.1566 · Cited by 5 · see citing works
Santiago-Torres, M., Mull, K. E., Sullivan, B. M., Prochaska, J. J., Zvolensky, M. J., & Bricker, J. B. (2024) · Depression and Anxiety · doi:10.1155/2024/1055801 · Cited by 3 · see citing works
“Most studies have been limited to small pilot randomized controlled trials (RCTs) and single-arm studies [43, 44, 45, 46, 47].”
Chan, A. S. W., Tan, R. K. J., Choong, A., Phang, K. C., Li, S., Wu, R., Tang, P. M. K., Ong, E. J., Cheung, J., Boonruang, J., et al. (2026) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1684834 · Cited by 2 · see citing works
Jayeoba, M., Scherr, C. L., Carroll, A. J., Daly, E., Kerstiens, S., Phillips, S. M., Hitsman, B. L., Garcia, S. F., Spring, B. J., & Jacobs, M. L. (2025) · Journal of Medical Internet Research · doi:10.2196/65975 · Cited by 2 · see citing works
Shoesmith, E., Huddlestone, L., Pervin, J., Williams, P. P., Sweetman, J., Johns, K., Crane, D., Ross, L., & Ratschen, E. (2025) · BMJ Public Health · doi:10.1136/bmjph-2025-002740 · Cited by 1 · see citing works
Buddrus, U., Kutza, J.-O., Thye, J., Esdar, M., Hübner, U. H., & Liebe, J.-D. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1755598 · Cited by 4 · see citing works
Shoesmith, E., Huddlestone, L., Pervin, J., Williams, P. P., Sweetman, J., Crane, D., Johns, K., Ross, L., & Ratschen, E. (2024) · doi:10.2196/preprints.68654
Evaluating Perceptions of the CANreduce 2.0 eHealth Intervention for Cannabis Use: Focus Group Study
Folch‐Sanchez, D., Pellicer-Roca, M., Sestelo, M. A., Zuluaga, P., Árias, F., Cortez, P., Amechat, S., Gil‐Berrozpe, G. J., Montes, E. L., Mercadé, C., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/65025
Self-citationInvestigating Persuasive Software Features for Addiction Recovery
Taskan, H. S., & B, H. O.-K. A. (2025) · Communications in computer and information science · doi:10.1007/978-3-031-97177-8_15
Chen, R., Tang, J., Zou, L., Zhou, Z., Xu, S., Huang, H., & Liao, Y. (2025) · doi:10.2196/preprints.84538
Bennett, M. E., Dickerson, F., Cha, S., Brandler, B. J., Lucksted, A. A., Medoff, D. R., Marano, C. M., Knight, S., & Graham, A. L. (2026) · Psychiatric Services · doi:10.1176/appi.ps.20250326
Sawyer, C. S., Hassan, L., Torous, J. B., Bucci, S., Crane, D., Sainsbury, J., Warrender, E., Gilbody, S. M., Lovell, K., & Firth, J. (2026) · Journal of Mental Health · doi:10.1080/09638237.2026.2672338
Self-citationKim, T. H., Seo, I. J., Kim, J. S., Yu, E., Kim, H. R., Han, L., & Kim, S. M. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1779824
- Authors
- Martinez Agulleiro, L., Patil, B., Firth, J., Sawyer, C., Amann, B. L., Fonseca, F., Torrens, M., Perez, V., Castellanos, F. X., Kane, J. M., & Guinart, D.
- Affiliations
- Maimonides Medical Center (US)
- Manchester Academic Health Science Centre (GB)
- Universitat Pompeu Fabra (ES)
- Universitat de Vic - Universitat Central de Catalunya (ES)
- Nathan Kline Institute for Psychiatric Research (US)
- Feinstein Institute for Medical Research (US)
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2023-05-10
- Volume
- 53
- Issue
- 11
- Pages
- 4856-4868
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC10476065
- OpenAlex
- W4376112512
- Cited by
- 19
- References
- 85
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 6
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, cc-by)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by-nc-nd)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking cessation, severe mental illness, digital interventions, mobile health, mindfulness, abstinence rates, treatment acceptability, usability, adverse events
- MeSH terms
- Tobacco Smoking, Mental Disorders, Humans, Smoking Cessation, Telemedicine, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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