The effectiveness of smoking cessation, physical activity/diet and alcohol reduction interventions delivered by mobile phones for the prevention of non-communicable diseases: A systematic review of randomised controlled trials
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BACKGROUND: We conducted a systematic review to assess the effectiveness of smoking cessation, physical activity (PA), diet, and alcohol reduction interventions delivered by mobile technology to prevent non-communicable diseases (NCDs). METHODS: We searched for randomised controlled trials (RCTs) of mobile-based NCD prevention interventions using MEDLINE, EMBASE, Global Health, CINAHL (Jan 1990-Jan 2016). Two authors extracted data. FINDINGS: 71 trials were included: smoking cessation (n = 18); PA (n = 15), diet (n = 3), PA and diet (n = 25); PA, diet, and smoking cessation (n = 2); and harmful alcohol consumption (n = 8). 4 trials had low risk of bias. The effect of SMS-based smoking cessation support on biochemically verified continuous abstinence was pooled relative risk [RR] 2.19 [95% CI 1.80-2.68], I2 = 0%) and on verified 7 day point prevalence of smoking cessation was pooled RR 1.51 [95% CI 1.06-2.15], I2 = 0%, with no reported adverse events. There was no difference in peak oxygen intake at 3 months in a trial of an SMS-based PA intervention. The effect of SMS-based diet and PA interventions on: incidence of diabetes was pooled RR 0.67 [95% CI 0.49, 0.90], I2 = 0.0%; end-point weight was pooled MD -0.99Kg [95% CI -3.63, 1.64] I2 = 29.4%; % change in weight was pooled MD -3.1 [95%CI -4.86- -1.3] I2 0.3%; and on triglyceride levels was pooled MD -0.19 mmol/L [95% CI -0.29, -0.08], I2 = 0.0%. The results of other pooled analyses of the effect of SMS-based diet and PA interventions were heterogenous (I2 59-90%). The effects of alcohol reduction interventions were inconclusive. CONCLUSIONS: Smoking cessation support delivered by SMS increases quitting rates. Trials of PA interventions reporting outcomes ≥3 months showed no benefits. There were at best modest benefits of diet and PA interventions. The effects of the most promising SMS-based smoking, diet and PA interventions on morbidity and mortality in high-risk groups should be established in adequately powered RCTs.
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Randomized controlled trials evaluating mHealth for promoting smoking cessation, physical activity, dietary improvement, alcohol reduction, and weight loss have had inconclusive findings.
“Despite numerous randomized controlled trials evaluating the effectiveness of mHealth for promoting smoking cessation, physical activity, dietary improvement, alcohol consumption reduction, and weight loss, the findings have been inconclusive.”
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“The results are influenced by various factors, including population characteristics, type of technology, lifestyle intervention, follow-up duration, health professional involvement, and comparator utilized [12,16,17].”
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- Authors
- Palmer, M., Sutherland, J., Barnard, S., Wynne, A., Rezel, E., Doel, A., Grigsby-Duffy, L., Edwards, S., Russell, S., Hotopf, E., Perel, P., & Free, C.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- King's College London (GB)
- City and Islington College (GB)
- Corresponding author
- Palmer, Melissa
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-01-05
- Volume
- 13
- Issue
- 1
- Pages
- e0189801
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5755775
- OpenAlex
- W2781958463
- Cited by
- 136
- References
- 109
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 17 · 2023: 18 · 2022: 23 · 2021: 22 · 2020: 20 · 2019: 11 · 2018: 12
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- World Health Organization
- National Institute for Health and Care Research (NF-SI-0515-10102, NF-SI-0507-10088)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- mobile health, text messaging, smoking cessation, physical activity interventions, dietary intervention, alcohol consumption reduction, non-communicable disease prevention, text messaging intervention, diabetes prevention, weight loss, triglycerides, harm reduction
- MeSH terms
- Noncommunicable Diseases, Alcohol Drinking, Diet, Humans, Exercise, Randomized Controlled Trials as Topic, Smoking Cessation, Outcome Assessment, Health Care, Cell Phone, Text Messaging, Alcohol Abstinence
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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.
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