Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot

Background: Cigarette smoking poses a major public health risk, requiring scalable and accessible interventions. Chatbots offer a promising solution, given their potential in providing personalized, long-term interactions. Despite their promise, limited research has examined their efficacy and the i...

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Main Authors: Linwei He, Erkan Basar, Reinout W. Wiers, Marjolijn L. Antheunis, Emiel Krahmer
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Internet Interventions
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214782925000077
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author Linwei He
Erkan Basar
Reinout W. Wiers
Marjolijn L. Antheunis
Emiel Krahmer
author_facet Linwei He
Erkan Basar
Reinout W. Wiers
Marjolijn L. Antheunis
Emiel Krahmer
author_sort Linwei He
collection DOAJ
description Background: Cigarette smoking poses a major public health risk, requiring scalable and accessible interventions. Chatbots offer a promising solution, given their potential in providing personalized, long-term interactions. Despite their promise, limited research has examined their efficacy and the intertwined relationship between user experience and effectiveness over an extended period of time. Methods: In this prospective, single-arm study, we developed and evaluated Roby, a 5-session chatbot intervention incorporating motivational interviewing and cognitive behavioral therapy to help smokers quit. Roby engaged Dutch adult smokers (N = 102) in conversations covering topics such as setting a quit date, managing withdrawal and cravings, and relapse prevention. The primary outcome was the continuous abstinence rate at the end of the intervention, and secondary outcomes included 7-day point prevalence abstinence, self-efficacy, and cravings. User engagement, therapeutic alliance, and interaction satisfaction were measured weekly, and the trajectory was analyzed using Linear Mixed Models. Results: Following an intention-to-treat principle, 18.6 % of participants achieved continuous abstinence, and 37.3 % achieved 7-day point prevalence abstinence. Self-efficacy significantly improved over the intervention, and cravings decreased over time. A slight decreasing trend was observed in engagement and satisfaction, likely due to a novelty effect. However, the decrease did not affect the intervention's outcomes. Conclusion: This study demonstrates the feasibility and initial usefulness of Roby, highlighting the potential for chatbots in long-term cessation support. Future research should further validate these findings with randomized controlled trials. Additional efforts should focus on monitoring and maintaining user experience in the long term to enhance effectiveness.
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spelling doaj-art-89e4a6c3ad9c40d582dff5d5eb4888d02025-02-07T04:47:39ZengElsevierInternet Interventions2214-78292025-03-0139100806Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbotLinwei He0Erkan Basar1Reinout W. Wiers2Marjolijn L. Antheunis3Emiel Krahmer4Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands; Corresponding author at: Dante building D407, Warandelaan 2, Tilburg 5037AB, the Netherlands.Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, the NetherlandsAddiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, the NetherlandsDepartment of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the NetherlandsDepartment of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the NetherlandsBackground: Cigarette smoking poses a major public health risk, requiring scalable and accessible interventions. Chatbots offer a promising solution, given their potential in providing personalized, long-term interactions. Despite their promise, limited research has examined their efficacy and the intertwined relationship between user experience and effectiveness over an extended period of time. Methods: In this prospective, single-arm study, we developed and evaluated Roby, a 5-session chatbot intervention incorporating motivational interviewing and cognitive behavioral therapy to help smokers quit. Roby engaged Dutch adult smokers (N = 102) in conversations covering topics such as setting a quit date, managing withdrawal and cravings, and relapse prevention. The primary outcome was the continuous abstinence rate at the end of the intervention, and secondary outcomes included 7-day point prevalence abstinence, self-efficacy, and cravings. User engagement, therapeutic alliance, and interaction satisfaction were measured weekly, and the trajectory was analyzed using Linear Mixed Models. Results: Following an intention-to-treat principle, 18.6 % of participants achieved continuous abstinence, and 37.3 % achieved 7-day point prevalence abstinence. Self-efficacy significantly improved over the intervention, and cravings decreased over time. A slight decreasing trend was observed in engagement and satisfaction, likely due to a novelty effect. However, the decrease did not affect the intervention's outcomes. Conclusion: This study demonstrates the feasibility and initial usefulness of Roby, highlighting the potential for chatbots in long-term cessation support. Future research should further validate these findings with randomized controlled trials. Additional efforts should focus on monitoring and maintaining user experience in the long term to enhance effectiveness.http://www.sciencedirect.com/science/article/pii/S2214782925000077Conversational agentsChatbotsSmoking cessationEngagementLongitudinal evaluationUser experience
spellingShingle Linwei He
Erkan Basar
Reinout W. Wiers
Marjolijn L. Antheunis
Emiel Krahmer
Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
Internet Interventions
Conversational agents
Chatbots
Smoking cessation
Engagement
Longitudinal evaluation
User experience
title Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
title_full Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
title_fullStr Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
title_full_unstemmed Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
title_short Chatting your way to quitting: A longitudinal exploration of smokers' interaction with a cessation chatbot
title_sort chatting your way to quitting a longitudinal exploration of smokers interaction with a cessation chatbot
topic Conversational agents
Chatbots
Smoking cessation
Engagement
Longitudinal evaluation
User experience
url http://www.sciencedirect.com/science/article/pii/S2214782925000077
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