Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2026: Engagement-Focused GenAI-based Chatbot for Real-Time Smoking Cessation Support

Официальное название

Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2026: Real-time Smoking Cessation Instant Messaging Support Using a Engagement-Focused Large Language Model (LLM)-Based Chatbot

Обзор

The goal of this trial is to learn if chatbot-based instant messaging works to help smoking cessation in general adult smokers. It will also learn about the experience, attitude, and perception of using an LLM-based chatbot. The main questions it aims to answer are: 1. Will an engagement-focused LLM-based chatbot smoking cessation intervention have a non-inferior validated abstinence rate than the control group? 2. Will an LLM-based chatbot smoking cessation intervention have a non-inferior self-reported abstinence rate, smoking reduction rate, and smoking cessation services use rate than the control group? Researchers will compare an LLM-based chatbot smoking-cessation intervention to a human-led instant messaging support group (brief advice based on AWARD and personalised active referral) to determine whether chatbot-based instant messaging support promotes smoking cessation. Participants in the intervention group will receive: 1. AWARD advice 2. Personalised active referral 3. 12 weeks of chatbot-based instant messaging support (via WhatsApp)

Подробное описание

Although smoking prevalence in Hong Kong has declined to 9.1% in 2023, achieving the government's target of 7.8% by 2025 remains a major public health challenge. Unassisted "cold turkey" quitting has a long-term success rate of less than 5%, whereas evidence-based behavioural and pharmacological interventions can raise success rates to approximately 20% or higher. However, existing cessation services in Hong Kong face a critical utilisation gap: only 17.5% of smokers have engaged with professional services, and merely 23% have used nicotine replacement therapy. This underutilisation suggests that traditional human-resource-intensive models may lack accessibility, scalability, and local appeal. Generative AI, particularly large language models, offers a transformative solution by delivering consistent, scalable, and personalised support. In the 2025 "Quit to Win" round, investigators integrated an LLM-based chatbot via WhatsApp and received positive qualitative feedback. Yet quantitative analysis revealed a sharp decline in engagement, with weekly participation dropping from 32% in week 1 to 14% by week 12, indicating that conversational ability alone does not guarantee sustained user commitment. To address this implementation gap, investigators have developed an engagement-focused GenAI companion that incorporates structured onboarding, context-aware personalisation, multimodal (text/audio) input, empathetic support, habit-aligned reminders, localised humour, and gamified features such as success stories and knowledge quizzes. Therefore, the current study aims to test, via a two-arm non-inferiority randomised controlled trial, the effectiveness of a comprehensive intervention combining brief cessation advice (AWARD), personalised active referral, and this engagement-enhanced GenAI chatbot support compared with human-led instant messaging counselling among current smokers who join the Quit to Win Contest across all 18 districts of Hong Kong.

Вмешательства

• Поведенческое AWARD advice
  A brief (30-60 seconds) face-to-face or remote smoking cessation advice delivered using the validated AWARD model: Ask about smoking history; Warn about high health risks (accompanied by a health warning leaflet); Advise quitting as soon as possible and setting a quit date (to qualify for contest prizes); Refer to smoking cessation services using a referral card; Do it again - repeat the intervention at each follow-up, encouraging re-quitting after relapse or relapse prevention after success.
• Поведенческое Brief leaflet on health warning and smoking cessation
  A two-sided, colour-printed A4 leaflet covering: (1) absolute risk of death from smoking; (2) full list of diseases caused by active and second-hand smoking; (3) ten pictorial warnings of health consequences on one page for maximum impact; (4) benefits of smoking cessation; and (5) simple encouraging messages to quit.
• Поведенческое Referral card
  A three-folded card containing brief information and highlights of existing smoking cessation services in Hong Kong, contact methods, motivational messages, and strong supporting slogans.
• Поведенческое Self-help smoking cessation booklet
  A generic booklet provided covering: benefits of quitting, smoking-related diseases, methods to quit, how to handle withdrawal symptoms, a quitting declaration, and other practical tips.
• Поведенческое Personalized active referral
  Smokers will be introduced to various SC services in Hong Kong (via the referral card) and motivated to use them. Well-trained SC ambassadors will assist smokers in choosing their favourite or most convenient type of service. Research staff will assist participants in booking or re-booking the SC services at the 1- and 2-month follow-ups (after very brief questionnaire surveys). Participants' contact information will be forwarded to SC service providers within 7 days, and providers are expected
• Поведенческое 12 weeks of chatbot-based instant messaging support
  Participants in the intervention group will receive 12 weeks of instant messaging support delivered by an LLM-based chatbot (GPT-4o or newer) on WhatsApp, supporting text and audio input. Using prompt engineering, agent techniques, and Retrieval-Augmented Generation, the chatbot delivers theory-based 5As/5Rs-structured interventions alongside freeform, on-demand support, with engagement features including personalisation, proactive check-ins, and interactive Quick Commands.
• Поведенческое 12 weeks of human-led instant messaging support
  Participants in the control group will receive 12 weeks of instant messaging support delivered by a trained human counsellor via WhatsApp. Using the same theoretical frameworks as the chatbot intervention, the counsellor will provide real-time behavioural and psychosocial support grounded in the 5As/5Rs models, Motivational Interviewing (MI), and evidence-based Behaviour Change Techniques (BCTs). The support will be personalised according to each participant's sociodemographic characteristics, s
• Поведенческое Reminder messages
  WhatsApp messages on follow-up survey reminders.

Первичные конечные точки

• Biochemically validated abstinence [Срок оценки: 6-month follow-up]

Вторичные конечные точки (10)

• Biochemically validated abstinence [Срок оценки: 3-month follow-up]
• Self-reported 7-day point prevalence abstinence [Срок оценки: 3- and 6-month follow-ups]
• Self-reported reduction [Срок оценки: 1-, 2-, 3- and 6-month follow-ups]
• Self-reported use of smoking cessation service [Срок оценки: 1-, 2-, 3- and 6-month follow-ups]
• Prolonged abstinence [Срок оценки: 3-month and 6-month follow-ups]
• Quit attempt [Срок оценки: 1-, 2-, 3-, and 6-month follow-ups]
• Post-cessation weight change [Срок оценки: 6-month follow-up]
• Self-reported mental health conditions [Срок оценки: Baseline and 6-month follow-up]
• Self-reported smoking-related health conditions [Срок оценки: Baseline and 6-month follow-up]
• Chatbot user experience [Срок оценки: 3-month follow-up]

Критерии участия

Критерии включения

• Hong Kong residents aged 18 years or above
• Smoke at least one cigarette (including heated tobacco products) per day or use an e-cigarette daily in the preceding 3 months
• Able to communicate in Cantonese (including reading and writing Chinese)
• Saliva cotinine level ≥30 ng/mL
• Intention to quit or reduce smoking
• Have WhatsApp installed
• Able to use WhatsApp for communication

Критерии исключения

• Smokers who have communication barriers (either physical or cognitive)
• Smokers who are currently participating in other smoking cessation programs or services

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Организация здравоохранения

Центры проведения

Гонконг · 1 центр

• Hong Kong Council on Smoking and Health (COSH) — Гонконг

Идентификаторы

NCT: NCT07649044 · QTW2026

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗