Mapping the effectiveness of digital health interventions in promoting electronic cigarette cessation: a systematic...

This study aims to evaluate the effectiveness of digital health interventions (DHI) in promoting e-cigarette smoking cessation and explore the nature of the relationship between digital determinants of health (DDOH) and intervention successes.

Randomized controlled trials (RCTs) that utilized various forms of DHIs were explored in PubMed-MEDLINE, Science Direct, Scopus, and Embase, along with Google Scholar for retrieving relevant grey literature from inception till 10th June, 2025. The quality assessment of the included studies was conducted using the latest Cochrane Risk of Bias Assessment (ROBVIS 2). Meta-analysis was done to present the overall effect size (odds ratio) of the DHIs in improving e-cigarette cessation and promoting its abstinence among users (frequent and occasional). A correlation heatmap was prepared, which focused on the nature of the relationship between DHI's DDOH.

A total of ten studies were included in this review, with an overall sample size of 7424. Interactive and fully automated SMS-based text messages (health) emerged as the most commonly used intervention method. Results from the meta-analysis showed a pooled effect size of 2.23 (odds ratio) at 95% CI (1.06, 2.08), indicating its statistical significance at p = 0.002 and overall test effect (Z-score) at 3.14 [tau² = 0.031; Chi² = 63.43, df = 5, P < 0.001]. This illustrates the effectiveness of DHI in improving e-cigarette cessation efforts. A correlation analysis demonstrated a moderate to very strong and positive correlation (0.542 to 0.955; p < 0.05 at 95% C.I) between DDOH and digital intervention success for e-cigarette smoking cessation. Additionally, quality assessment of the included studies (n = 10) indicated a lower risk of bias by 60% (n = 6), suggesting an overall higher level of confidence and reliability in the existing evidence on this subject.

This review demonstrated the promising potential of DHIs in leveraging efforts to promote e-cigarette cessation. The study revealed that for any DHI to be successful in its objective, the developers of the interventions must focus on DDOH, as it plays a crucial role in enhancing user experience and adherence to the intended intervention.