ChatGPT-Based Chatbot for Help Quitting Smoking via Text Messaging: An Interventional Study

Document Type

Journal Article

Publication Date

10-10-2025

Journal

JMIR formative research

Volume

9

DOI

10.2196/79402

Keywords

ChatGPT; SMS text messaging; artificial intelligence; chatbots; cigarettes; large language model; smoking cessation; tobacco

Abstract

BACKGROUND: Large language model chatbots such as ChatGPT may be able to provide support to people who smoke cigarettes and are trying to quit. OBJECTIVE: This pilot study examined the feasibility and acceptability of integrating a specialized ChatGPT-based chatbot, BeFreeBot, into a smoking cessation text messaging intervention, BeFree. Chatbot fidelity was also examined. METHODS: Participants who smoked cigarettes in the previous 7 days were recruited from Amazon Mechanical Turk (N=23), enrolled in BeFree, and provided access to BeFreeBot. Surveys were administered at baseline and 4 weeks after enrollment to assess perceptions of BeFreeBot. Computer records of interactions between BeFreeBot and participants were also analyzed to assess participant engagement and adherence of BeFreeBot to its instructions. For the adherence analysis, transcripts were dual coded, and discrepancies were resolved by a third coder. RESULTS: Most participants (16/23, 70%) texted BeFreeBot with questions or concerns at least once. Participants sent 14.5 (SD 23.6) texts to BeFreeBot on average. Most participants were highly satisfied with BeFreeBot (13/18, 72%) and agreed that it was helpful for quitting (11/19, 58%). They also reported that the BeFreeBot responses were clear and easy to understand (16/17, 94%) and that they trusted responses from BeFreeBot (12/17, 71%). Most participants (17/19, 90%) reported trying to quit smoking for 1 day or longer, and 30% (7/23) self-reported no smoking in the previous 7 days. An analysis of transcripts of BeFreeBot responses (n=328) revealed that BeFreeBot functioned as instructed on most measures, with clear language (328/328, 100%), follow-up questions asked of participants (13/16, 81%), and recommendations to seek out professional counseling (13/16, 81%) or consider the use of Food and Drug Administration-approved medications (eg, nicotine replacement therapy; 14/16, 88%). Responses stayed on the topic of smoking cessation counseling (324/328, 98.8%) and did not include information that contradicted the US Preventive Services Task Force guidelines (328/328, 100%). CONCLUSIONS: A specialized large language model chatbot integrated into an SMS text messaging program and accessed through SMS text message was found to be feasible and acceptable to smokers.

Department

Prevention and Community Health

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