Skip to content

Digital Education for Health Professions on Smoking Cessation Management: Systematic Review by the Digital Health Education Collaboration

Research output: Contribution to journalReview article

  • Monika Semwal
  • Penny Whiting
  • Ram Bajpai
  • Shweta Bajpai
  • Bhone Myint Kyaw
  • Lorainne Tudor Car
Original languageEnglish
Pages (from-to)e13000
JournalJournal of Medical Internet Research
Issue number3
DateAccepted/In press - 1 Feb 2019
DatePublished (current) - 4 Mar 2019


BACKGROUND: Tobacco smoking, one of the leading causes of preventable death and disease, is associated with 7 million deaths every year. This is estimated to rise to more than 8 million deaths per year by 2030, with 80% occurring in low- and middle-income countries. Digital education, teaching, and learning using digital technologies have the potential to increase educational opportunities, supplement teaching activities, and decrease distance barriers in health professions education.

OBJECTIVE: The primary objective of this systematic review was to evaluate the effectiveness of digital education compared with various controls in improving learners' knowledge, skills, attitudes, and satisfaction to deliver smoking cessation therapy. The secondary objectives were to assess patient-related outcomes, change in health professionals' practice or behavior, self-efficacy or self-rated competence of health professionals in delivering smoking cessation therapy, and cost-effectiveness of the interventions.

METHODS: We searched 7 electronic databases and 2 trial registers for randomized controlled trials published between January 1990 and August 2017. We used gold standard Cochrane methods to select and extract data and appraise eligible studies.

RESULTS: A total of 11 studies (number of participants, n=2684) were included in the review. All studies found that digital education was at least as effective as traditional or usual learning. There was some suggestion that blended education results in similar or greater improvements in knowledge (standardized mean difference, SMD=0.19, 95% CI -0.35 to 0.72), skill (SMD=0.58, 95% CI 0.08-1.08), and satisfaction (SMD=0.62, 95% CI 0.12-1.12) compared with digital education or usual learning alone. There was also some evidence for improved attitude (SMD=0.45, 95% CI 0.18-0.72) following digital education compared with usual learning. Only 1 study reported patient outcomes and the setup cost of blended education but did not compare outcomes among groups. There were insufficient data to investigate what components of the digital education interventions were associated with the greatest improvements in learning outcomes.

CONCLUSIONS: The evidence suggests that digital education is at least as effective as usual learning in improving health professionals' knowledge and skill for delivering smoking cessation therapy. However, limitations in the evidence base mean that these conclusions should be interpreted with some caution.


Additional information

©Monika Semwal, Penny Whiting, Ram Bajpai, Shweta Bajpai, Bhone Myint Kyaw, Lorainne Tudor Car. Originally published in the Journal of Medical Internet Research (, 04.03.2019.

    Research areas

  • evidence-based practice, health personnel, learning, smoking cessation, systematic review

Download statistics

No data available



  • Full-text PDF (final published version)

    Rights statement: This is the final published version of the article (version of record). It first appeared online via JMIR at . Please refer to any applicable terms of use of the publisher.

    Final published version, 605 KB, PDF document

    Licence: CC BY


View research connections

Related faculties, schools or groups