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Background Tobacco quitlines provide effective resources (eg, nicotine replacement therapy, smoking cessation counseling, and text and web-based support) for those who want to quit smoking in the United States. However, quitlines reach approximately only 1%-3% of people who smoke each year. Novel, smartphone-based, and low-burden interventions that offer 24/7 access to smoking cessation resources that are tailored to current readiness to quit may increase appeal, reach, and effectiveness of smoking cessation interventions. Objective This study will examine the efficacy of OKquit, a low-burden smartphone-based app for smoking cessation. Methods Approximately 500 people who smoke cigarettes and access the Oklahoma Tobacco Helpline (OTH) will be randomized to receive standard OTH care (SC) or SC plus the novel OKquit smartphone app for smoking cessation (OKquit). All participants will use a smartphone app to complete study surveys (ie, baseline, 27 weekly surveys, brief daily check-ins, and 27-week follow-up). Upon completion of daily check-ins and weekly surveys, participants will receive either trivia type messages (SC) or messages that are tailored to current readiness to quit smoking and currently experienced lapse triggers (OKquit). In addition, those assigned to receive the OKquit app will have access to on-demand smoking cessation content (eg, quit tips, smoking cessation medication tips). It is hypothesized that participants assigned to OKquit will be more likely to achieve biochemically verified 7-day point prevalence abstinence than those assigned to SC at 27 weeks post enrollment. In addition, participants who use more OTH resources (eg, more cessation coaching sessions completed) or more OKquit resources (eg, access more quit tips) will have greater biochemically verified smoking cessation rates. Results Data collection began in September 2022 and final follow-ups are expected to be completed by May 2025. Conclusions Data from this randomized controlled trial will determine whether the OKquit smartphone app combined with OTH care will increase smoking cessation rates over standard OTH care alone. If successful, OKquit could provide tailored intervention content at a fraction of the cost of traditional interventions. Furthermore, this type of low-burden intervention may offer a way to reach underserved populations of adults who smoke and want to quit. Trial Registration ClinicalTrials.gov NCT05539209; https://clinicaltrials.gov/study/NCT05539209 International Registered Report Identifier (IRRID) DERR1-10.2196/56827
Background Tobacco quitlines provide effective resources (eg, nicotine replacement therapy, smoking cessation counseling, and text and web-based support) for those who want to quit smoking in the United States. However, quitlines reach approximately only 1%-3% of people who smoke each year. Novel, smartphone-based, and low-burden interventions that offer 24/7 access to smoking cessation resources that are tailored to current readiness to quit may increase appeal, reach, and effectiveness of smoking cessation interventions. Objective This study will examine the efficacy of OKquit, a low-burden smartphone-based app for smoking cessation. Methods Approximately 500 people who smoke cigarettes and access the Oklahoma Tobacco Helpline (OTH) will be randomized to receive standard OTH care (SC) or SC plus the novel OKquit smartphone app for smoking cessation (OKquit). All participants will use a smartphone app to complete study surveys (ie, baseline, 27 weekly surveys, brief daily check-ins, and 27-week follow-up). Upon completion of daily check-ins and weekly surveys, participants will receive either trivia type messages (SC) or messages that are tailored to current readiness to quit smoking and currently experienced lapse triggers (OKquit). In addition, those assigned to receive the OKquit app will have access to on-demand smoking cessation content (eg, quit tips, smoking cessation medication tips). It is hypothesized that participants assigned to OKquit will be more likely to achieve biochemically verified 7-day point prevalence abstinence than those assigned to SC at 27 weeks post enrollment. In addition, participants who use more OTH resources (eg, more cessation coaching sessions completed) or more OKquit resources (eg, access more quit tips) will have greater biochemically verified smoking cessation rates. Results Data collection began in September 2022 and final follow-ups are expected to be completed by May 2025. Conclusions Data from this randomized controlled trial will determine whether the OKquit smartphone app combined with OTH care will increase smoking cessation rates over standard OTH care alone. If successful, OKquit could provide tailored intervention content at a fraction of the cost of traditional interventions. Furthermore, this type of low-burden intervention may offer a way to reach underserved populations of adults who smoke and want to quit. Trial Registration ClinicalTrials.gov NCT05539209; https://clinicaltrials.gov/study/NCT05539209 International Registered Report Identifier (IRRID) DERR1-10.2196/56827
BACKGROUND Large Language Model (LLM) AI chatbots using generative language can offer smoking cessation information and advice. However, little is known about the reliability of information provided to users. OBJECTIVE This study aims to examine whether 3 ChatGPT chatbots – the World Health Organization’s (WHO) Sarah, BeFreeGPT, and BasicGPT – provide reliable information on how to quit smoking. METHODS A list of quit smoking queries was generated from frequent quit smoking searches on Google related to “how to quit smoking” (N=12). Each query was given to each chatbot, and responses were analyzed for their adherences to an index developed from the United States Preventive Services Task Force (USPSTF) public health guidelines for quitting smoking and counseling principles. Responses were independently coded by 2 reviewers and differences resolved by a third coder. RESULTS Across chatbots and queries, chatbot responses were rated as being adherent to 57.1% of the items on the adherence index. Sarah’s adherence (72.2%) was significantly higher than BeFreeGPT (50.0%) and BasicGPT (47.8%) (p<.01). The majority of Chatbot responses had clear language (97.3%) and included a recommendation to seek out professional counseling (80.3%). About half of responses included the recommendation to consider using nicotine replacement therapy (NRT) (52.7%), the recommendation to seek out social support from friends and family (55.6%), and information on how to deal with cravings when quitting smoking (44.4%). Least common was information about considering the use of non-NRT prescription drugs (14.1%). Finally, some type of misinformation was present in 22.0% of responses. Specific queries that were most challenging for the chatbots included queries on “how to quit smoking cold turkey,” “… with vapes,” “…with gummies,” “…with a necklace,” and “…with hypnosis.” All chatbots showed resilience to adversarial attacks that were intended to derail the conversation. CONCLUSIONS LLM chatbots varied in their adherence to quit smoking guidelines and counseling principles. While chatbots reliably provided some types of information, they omitted other types, as well as occasionally provided misinformation, especially for queries about less evidence-based methods of quitting. LLM chatbot instructions can be revised to compensate for these weaknesses. CLINICALTRIAL n/a
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