Effect of mobile interventions with nicotine replacement
therapy sampling on long-term smoking cessation in
community smokers: A pragmatic randomized clinical trial

Guo, Ningyuan; Luk, Tzu Tsun; Wu, Yongda; Guo, Ziqiu; Chu, Jessica Chi Lok; Cheung, Yee Tak Derek; Chan, Ching Han Helen; Kwok, Tyrone Tai On; Wong, Victor Yiu Lun; Wong, Carlos King Ho; Lee, Jung Jae; Kwok, Yue Kuen; Viswanath, Kasisomayajula; Lam, Tai Hing; Wang, Man Ping

doi:10.18332/tid/160168

Cited by 5 publications

References 35 publications

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Mobile Phone–Based Personalized and Interactive Augmented Reality Pictorial Health Warnings for Enhancing a Brief Advice Model for Smoking Cessation: Pilot Randomized Controlled Trial

Guo,

Wu,

Wang

2024

JMIR XR Spatial Comput

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Background Augmented reality (AR) is a novel modality for promoting smoking cessation (SC). AR-visualized adverse consequences for education and smoking prevention have only been evaluated in nonsmokers in previous studies. Objective To assess the feasibility and preliminary effectiveness for SC of AR pictorial health warnings (PHWs) on cigarette packs. Methods We conducted a pilot randomized controlled trial in adult daily smokers in communities in Hong Kong. All participants received AWARD (ask, warn, advise, referral, do-it-again) model–guided SC advice, a warning leaflet, and referral to SC services at baseline. Interactive, chat-based SC support comprising regular messages and real-time support was provided to all participants via instant messaging apps (eg, WhatsApp) for 3 months after randomization. Participants in the intervention group additionally received 6 links to the AR PHWs showing the worsening health status of various organs caused by smoking. The level of the AR PHWs was adjustable to smoking behaviors (ie, smoking duration or daily cigarette consumption) to increase interaction. Participants could swipe, drag, or rotate the 3D PHWs to reinforce their impression of the health consequences of smoking. The primary outcome was self-reported past 7-day point-prevalence abstinence (PPA) at 3 months. The acceptability of the AR intervention was assessed by the proportion of participants who had viewed AR PHWs during the intervention. Participants who viewed AR PHWs further evaluated the perceived effect of the AR PHWs on a scale of 0 (not helpful at all) to 10 (very helpful). Intention to treat was used, and the risk ratio (RR) of the intervention effect was estimated by Poisson regression. Results From April to November 2021, 80 participants were recruited and randomly assigned to intervention (n=40) and control (n=40) groups. Most participants were male (66/80, 83%) and planned to quit beyond 30 days or were undecided (65/80, 81%). The intervention group had a higher but nonsignificant 7-day PPA (7/40, 18% vs 5/40, 13%; RR 1.40, 95% CI 0.48-4.07) and quit attempts (15/40, 38% vs 11/40, 28%; RR 1.36, 95% CI 0.71-2.60) at 3 months than the control group. In the intervention group, 17 of 40 (43%) participants viewed the AR PHWs. The AR PHWs had modest effects on knowledge of the adverse consequences of smoking on personal health (mean score 3.94, SD 3.52), reducing the frequency of buying cigarettes (mean score 3.29, SD 3.08), increasing the perceived importance of quitting (mean score 3.88, SD 3.50), and making the PHWs more disgusting (mean score 3.41, SD 3.08) and horrible (mean score 3.38, SD 3.05). The 3-month self-reported 7-day PPA was higher in those who ever (vs never) viewed the AR PHWs (5/17, 29% vs 2/23, 9%). Conclusions The mobile-based interactive AR PHWs were feasible, and the effectiveness on smoking abstinence warrants further testing. Trial Registration ClinicalTrials.gov NCT04830072; https://clinicaltrials.gov/study/NCT04830072

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Mobile Phone–Based Personalized and Interactive Augmented Reality Pictorial Health Warnings for Enhancing a Brief Advice Model for Smoking Cessation: Pilot Randomized Controlled Trial

Guo,

Wu,

Wang

2024

JMIR XR Spatial Comput

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Roles, Users, Benefits, and Limitations of Chatbots in Health Care: Rapid Review

Laymouna,

Ma,

Lessard

et al. 2024

J Med Internet Res

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Background Chatbots, or conversational agents, have emerged as significant tools in health care, driven by advancements in artificial intelligence and digital technology. These programs are designed to simulate human conversations, addressing various health care needs. However, no comprehensive synthesis of health care chatbots’ roles, users, benefits, and limitations is available to inform future research and application in the field. Objective This review aims to describe health care chatbots’ characteristics, focusing on their diverse roles in the health care pathway, user groups, benefits, and limitations. Methods A rapid review of published literature from 2017 to 2023 was performed with a search strategy developed in collaboration with a health sciences librarian and implemented in the MEDLINE and Embase databases. Primary research studies reporting on chatbot roles or benefits in health care were included. Two reviewers dual-screened the search results. Extracted data on chatbot roles, users, benefits, and limitations were subjected to content analysis. Results The review categorized chatbot roles into 2 themes: delivery of remote health services, including patient support, care management, education, skills building, and health behavior promotion, and provision of administrative assistance to health care providers. User groups spanned across patients with chronic conditions as well as patients with cancer; individuals focused on lifestyle improvements; and various demographic groups such as women, families, and older adults. Professionals and students in health care also emerged as significant users, alongside groups seeking mental health support, behavioral change, and educational enhancement. The benefits of health care chatbots were also classified into 2 themes: improvement of health care quality and efficiency and cost-effectiveness in health care delivery. The identified limitations encompassed ethical challenges, medicolegal and safety concerns, technical difficulties, user experience issues, and societal and economic impacts. Conclusions Health care chatbots offer a wide spectrum of applications, potentially impacting various aspects of health care. While they are promising tools for improving health care efficiency and quality, their integration into the health care system must be approached with consideration of their limitations to ensure optimal, safe, and equitable use.

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Chatbot-Led Support Combined With Counselor-Led Support on Smoking Cessation in China: Protocol for a Pilot Randomized Controlled Trial

Weng,

Yin,

Liu

et al. 2024

JMIR Res Protoc

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Background China has a large population of smokers, with half of them dependent on tobacco and in need of cessation assistance, indicating the need for mobile health (mHealth) to provide cessation support. Objective The study aims to assess the feasibility and preliminary effectiveness of combining chatbot-led support with counselor-led support for smoking cessation among community smokers in China. Methods This is a 2-arm, parallel, assessor-blinded, pilot randomized controlled trial nested in a smoke-free campus campaign in Zhuhai, China. All participants will receive brief face-to-face cessation advice and group cessation support led by a chatbot embedded in WeChat. In addition, participants in the intervention group will receive personalized WeChat-based counseling from trained counselors. Follow-up will occur at 1, 3, and 6 months after treatment initiation. The primary smoking outcome is bioverified abstinence (exhaled carbon monoxide <4 parts per million or salivary cotinine <30 ng/mL) at 6 months. Secondary outcomes include self-reported 7-day point prevalence of abstinence, smoking reduction rate, and quit attempts. Feasibility outcomes include eligibility rate, consent rate, intervention engagement, and retention rate. An intention-to-treat approach and regression models will be used for primary analyses. Results Participant recruitment began in March 2023, and the intervention began in April 2023. The data collection was completed in June 2024. The results of the study will be published in peer-reviewed journals and presented at international conferences. Conclusions This study will provide novel insights into the feasibility and preliminary effectiveness of a chatbot-led intervention for smoking cessation in China. The findings of this study will inform the development and optimization of mHealth interventions for smoking cessation in China and other low- and middle-income countries. Trial Registration ClinicalTrials.gov NCT05777005; https://clinicaltrials.gov/study/NCT05777005 International Registered Report Identifier (IRRID) DERR1-10.2196/58636

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Effect of mobile interventions with nicotine replacement therapy sampling on long-term smoking cessation in community smokers: A pragmatic randomized clinical trial

Cited by 5 publications

References 35 publications

Mobile Phone–Based Personalized and Interactive Augmented Reality Pictorial Health Warnings for Enhancing a Brief Advice Model for Smoking Cessation: Pilot Randomized Controlled Trial

Mobile Phone–Based Personalized and Interactive Augmented Reality Pictorial Health Warnings for Enhancing a Brief Advice Model for Smoking Cessation: Pilot Randomized Controlled Trial

Roles, Users, Benefits, and Limitations of Chatbots in Health Care: Rapid Review

Chatbot-Led Support Combined With Counselor-Led Support on Smoking Cessation in China: Protocol for a Pilot Randomized Controlled Trial

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