Comparing the Efficacy of a Conversational Agent (QuitBot) Versus Standard Health Education on Smoking Cessation Among Medical Students; A Randomized Controlled Trial.

Conversational Agent, Smoking Cessation

Smoking cessation

Comparing the efficacy of conversational agent and standard health education in promoting smoking cessation among medical students in Cairo university

Tobacco smoking remains one of the leading causes of preventable morbidity and mortality worldwide, accounting for more than 8 million deaths annually (world health organization, 2023). Smoking among medical students represents a critical paradox in public health. As future physicians, they are expected to be role models and champions of preventive health, yet global studies indicate a persistent and concerning prevalence of tobacco use within this group, with rates varying from 5% to over 30% in different regions (AlSairafi & AlKandari, 2023). In Egypt, the situation is particularly pressing; a recent systematic review estimated the pooled prevalence of smoking among medical students to be approximately 18.5%, with some studies reporting rates as high as 28% among males (El-Masry et al., 2023). This high prevalence is often attributed to intense academic stress, social factors, and the normalization of smoking in certain environments (Bassiony et al., 2015). This behavior undermines their personal health and future professional credibility and effectiveness in tobacco cessation counseling Digital health technologies have emerged as effective and scalable tools for behavior change interventions. Mobile applications, web-based programs, and short message service (SMS) based interventions have demonstrated modest but significant effects on smoking cessation outcomes (whittaker et al., 2019). Among these digital approaches, conversational agents, or chatbots, offer unique advantages through real-time, interactive, and personalized communication (abdullah et al., 2023). Chatbots simulate human conversation and can provide continuous motivational and cognitive-behavioral support using natural language processing algorithms. Their 24/7 availability, anonymity, and ability to tailor responses based on user input make them highly suitable for youth and young adults who are digitally literate and familiar with online interaction (prochaska et al., 2021). So, This study hypothesizes that medical students who smoke and receive the combined intervention of the "QuitBot" conversational agent plus an evidence-based cessation guidelines will demonstrate a statistically significant higher rate of day point prevalence smoking abstinence and prolonged abstinence at 1 and 3months respectively post-intervention, compared to those who receive the evidence-based handbook alone. Since many similar studies have been conducted in high-income countries, there is very limited evidence from low- and middle-income contexts such as Egypt (el-amin et al., 2021). Medical students in Egypt are an ideal population for testing the feasibility of such a digital intervention, given their high rates of smartphone ownership and social media use. So, implementing quitbot among medical students could provide valuable insights into the acceptability, usability, and effectiveness of chatbot-based smoking cessation tools. Furthermore, this approach aligns with the global public health objective of integrating artificial intelligence-driven behavioral interventions into preventive healthcare strategies (world health organization, 2023).

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