Chatbots for Smoking Cessation: Scoping Review

Abstract

Background Despite significant progress in reducing tobacco use over the past 2 decades, tobacco still kills over 8 million people every year. Digital interventions, such as text messaging, have been found to help people quit smoking. Chatbots, or conversational agents, are new digital tools that mimic instantaneous human conversation and therefore could extend the effectiveness of text messaging. Objective This scoping review aims to assess the extent of research in the chatbot literature for smoking cessation and provide recommendations for future research in this area. Methods Relevant studies were identified through searches conducted in Embase, MEDLINE, APA PsycINFO, Google Scholar, and Scopus, as well as additional searches on JMIR, Cochrane Library, Lancet Digital Health, and Digital Medicine. Studies were considered if they were conducted with tobacco smokers, were conducted between 2000 and 2021, were available in English, and included a chatbot intervention. Results Of 323 studies identified, 10 studies were included in the review (3 framework articles, 1 study protocol, 2 pilot studies, 2 trials, and 2 randomized controlled trials). Most studies noted some benefits related to smoking cessation and participant engagement; however, outcome measures varied considerably. The quality of the studies overall was low, with methodological issues and low follow-up rates. Conclusions More research is needed to make a firm conclusion about the efficacy of chatbots for smoking cessation. Researchers need to provide more in-depth descriptions of chatbot functionality, mode of delivery, and theoretical underpinnings. Consistency in language and terminology would also assist in reviews of what approaches work across the field.

Experts’ views on translating NHS support to stop smoking in pregnancy into a comprehensive digital intervention

“…Artificial intelligence (AI) chatbots might offer a solution to replicating human-like interactions. There is some promising evidence that chatbots increase user engagement with generic digital cessation interventions [ 43 , 44 ] and help foster a sense of accountability [ 45 ]. However, among the existing studies there is variation in the sophistication of chatbot technologies and how they are delivered which might have implications not only for engagement and effectiveness with them as a cessation tool, but for development and maintenance costs.…”

Chatbots and COVID-19: Taking Stock of the Lessons Learned

“…They range from vaccine hesitancy and equity in access to relevant information [13][14][15] to pandemic-related mental health [16][17][18][19]. A number of topics focus on health promotion interventions, such as smoking cessation [20], as well as encouraging physical activity [21] and tooth-brushing [22]. Although the topics are diverse, some common themes have emerged from these explorations, namely, the importance of considering user experience in chatbot design, the need to make chatbots inclusive, and the importance of user trust [23].…”

Introducing Quin: The Design and Development of a Prototype Chatbot to Support Smoking Cessation

“…A recent scoping review of chatbots for smoking cessation found limited low-quality evidence to support the effectiveness of their use in usual care, but found anecdotal evidence of their benefits to smoking cessation and user engagement. 34 Randomized controlled trials of conversational AI for smoking cessation are often limited by low follow-up rates and there is significant heterogeneity between interventions and study designs. 35 Furthermore, there is limited evidence describing the development methods for smoking cessation chatbots.…”