AI-Enabled Personalized Smoking Cessation Intervention With the Aipaca Chatbot: Mixed Methods Feasibility Study
Notice bibliographique
Résumé
BACKGROUND: Tobacco use remains the leading cause of preventable mortality in the United States; yet, evidence-based cessation services remain underused due to staffing constraints, limited access to counseling, and competing clinical priorities. Generative artificial intelligence (GenAI) chatbots may address these barriers by delivering personalized, guideline-aligned counseling through naturalistic dialogue. However, little is known about how GenAI chatbots support smoking cessation at both outcome and communication process levels. OBJECTIVE: This feasibility study evaluated the implementation of an evidence-based smoking cessation counseling session delivered by a GenAI-powered chatbot, Aipaca. We examined (1) pre-post changes in cessation preparedness, (2) communication dynamics during counseling sessions, and (3) user perceptions of the chatbot's value, limitations, and design needs. METHODS: We conducted an observational, single-arm, mixed methods study with 29 adult smokers. Participants completed pre-post surveys measuring knowledge of smoking-related health risks and cessation methods, self-efficacy, and readiness to quit. Each engaged in a 30-minute text-based counseling session with Aipaca, powered by GPT-4 and structured using the 5A's framework (Ask, Advise, Assess, Assist, Arrange). Sessions were transcribed for microsequential conversation analysis. Twenty-five participants completed semistructured interviews exploring perceived value, challenges, and design suggestions. Quantitative data were analyzed with paired-samples t tests, qualitative data were thematically analyzed, and transcripts were analyzed for interactional practices. The methodological strength of this study lies in its triangulated approach, which combines quantitative measurement of intervention effectiveness, qualitative analysis of user interviews, and conversational analysis of counseling transcripts to generate a comprehensive understanding of both outcomes and underlying mechanisms. RESULTS: Participants demonstrated significant improvements in all preparedness indicators: knowledge of health risks, knowledge of cessation methods, self-efficacy, and readiness to quit. Conversation analysis identified three recurrent patterns enabling counseling-relevant dynamics: (1) contextual referencing and continuity, (2) formulations with elaboration prompts, and (3) narrative progression toward collaborative planning. Interview themes underscored Aipaca's perceived value as an accessible, nonjudgmental, and motivating resource, capable of delivering personalized and interactive support. Criticisms included limited accountability, reduced cultural resonance, and overly goal-directed style. Participants emphasized design needs such as proactive engagement, gamified progress tracking, empathetic or anthropomorphic personas, and safeguards for accuracy. CONCLUSIONS: This mixed methods feasibility study demonstrates that GenAI can deliver evidence-based smoking cessation counseling with measurable short-term gains in cessation preparedness and process-level communication patterns consistent with motivational interviewing. Users valued Aipaca's accessibility, empathy, and personalization, while also articulating expectations for richer social roles and long-term accountability. Findings highlight both the promise and challenges of integrating GenAI into digital health: pairing adaptive language generation with human-centered design, embedding accuracy safeguards, and ensuring integration into multilevel cessation infrastructures will be essential for future clinical deployment.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».