Adaptive digital platforms for youth tobacco cessation: a meta-analytic evaluation of web-based behaviour change interventions

Digital behaviour change interventions delivered through web-adaptive platforms offer novel pathways for tobacco control in youth. However, the longitudinal efficacy of tailored online cessation tools remains underexplored. This meta-analysis evaluates the comparative effectiveness of dynamically tailored web interventions versus passive controls in youth smokers. Following PRISMA guidelines, we systematically searched six databases (PubMed, Cochrane, Web of Science, Embase, SCOPUS, and CINAHL) through January 2024. Seven randomized controlled trials (n = 5660) assessing adaptive web platforms for smokers aged 10-30 years were included, with methodological rigour assessed via Joanna Briggs Institute criteria. Adaptive interventions significantly improved self-reported abstinence versus controls [risk ratio (RR) = 2.19, 95% CI 1.48-3.24]. Efficacy varied by follow-up stage: 1-2-month RR = 1.56 (1.28-1.90), 2-3-month RR = 2.24 (1.64-3.07), 4-6-month RR = 1.62 (0.96-2.74), and 7-24-month RR = 1.54 (1.12-2.11). Biochemical validation data from three trials showed null effects (RR = 0.05, -0.09 to 0.18), revealing measurement discordance. Web-based adaptive tools demonstrate short-term efficacy in youth smoking cessation, yet require integration with objective verification protocols. Future implementations should prioritize real-world engagement metrics and standardized outcome reporting.