A review of computer and Internet-based interventions for smoking behavior Scott T. Walters a, T , Jo Anne Wright b , Ross Shegog c a University of Texas School of Public Health, 5323 Harry Hines Blvd, V8.112, Dallas, TX 75390-9128, United States b University of Michigan, United States c Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Texas Medical Center, Houston, United States Abstract This article reviews studies of computer and Internet-based interventions for smoking behavior, published between 1995 and August 2004. Following electronic and manual searches of the literature, 19 studies were identified that used automated systems for smoking prevention or cessation, and measured outcomes related to smoking behavior. Studies varied widely in methodology, intervention delivery, participant characteristics, follow-up period, and measurement of cessation. Of eligible studies, nine (47%) reported statistically significant or improved outcomes at the longest follow-up, relative to a comparison group. Few patterns emerged in terms of subject, design or intervention characteristics that led to positive outcomes. The bfirst generationQ format, where participants were mailed computer-generated feedback reports, was the modal intervention format and the one most consistently associated with improved outcomes. Future studies will need to identify whether certain patients are more likely to benefit from such interventions, and which pharmacological and behavioral adjuncts can best promote cessation. D 2005 Elsevier Ltd. All rights reserved. Keywords: Smoking; Cessation; Computer; Internet; Intervention 1. Introduction The recent Institute of Medicine (2001) report paints a picture of an outdated healthcare system in need of innovative and cost-saving methods for improving health outcomes. In this process, smoking 0306-4603/$ - see front matter D 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.addbeh.2005.05.002 T Corresponding author. Tel.: +1 214 648 1519; fax: +1 214 648 1081. E-mail address: scott.walters@utsouthwestern.edu (S.T. Walters). Addictive Behaviors 31 (2006) 264 – 277