Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2026: Engagement-Focused GenAI-based Chatbot for Real-Time Smoking Cessation Support (QTW2026)

June 9, 2026 updated by: Prof. Wang Man-Ping, The University of Hong Kong

Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2026: Real-time Smoking Cessation Instant Messaging Support Using a Engagement-Focused Large Language Model (LLM)-Based Chatbot

The goal of this trial is to learn if chatbot-based instant messaging works to help smoking cessation in general adult smokers. It will also learn about the experience, attitude, and perception of using an LLM-based chatbot. The main questions it aims to answer are:

  1. Will an engagement-focused LLM-based chatbot smoking cessation intervention have a non-inferior validated abstinence rate than the control group?
  2. Will an LLM-based chatbot smoking cessation intervention have a non-inferior self-reported abstinence rate, smoking reduction rate, and smoking cessation services use rate than the control group?

Researchers will compare an LLM-based chatbot smoking-cessation intervention to a human-led instant messaging support group (brief advice based on AWARD and personalised active referral) to determine whether chatbot-based instant messaging support promotes smoking cessation.

Participants in the intervention group will receive:

  1. AWARD advice
  2. Personalised active referral
  3. 12 weeks of chatbot-based instant messaging support (via WhatsApp)

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Although smoking prevalence in Hong Kong has declined to 9.1% in 2023, achieving the government's target of 7.8% by 2025 remains a major public health challenge. Unassisted "cold turkey" quitting has a long-term success rate of less than 5%, whereas evidence-based behavioural and pharmacological interventions can raise success rates to approximately 20% or higher. However, existing cessation services in Hong Kong face a critical utilisation gap: only 17.5% of smokers have engaged with professional services, and merely 23% have used nicotine replacement therapy. This underutilisation suggests that traditional human-resource-intensive models may lack accessibility, scalability, and local appeal. Generative AI, particularly large language models, offers a transformative solution by delivering consistent, scalable, and personalised support. In the 2025 "Quit to Win" round, we integrated an LLM-based chatbot via WhatsApp and received positive qualitative feedback. Yet quantitative analysis revealed a sharp engagement decline, with weekly participation dropping from 32% in week 1 to 14% by week 12, indicating that conversational ability alone does not guarantee sustained user commitment. To address this implementation gap, we have developed an engagement-focused GenAI companion that incorporates structured onboarding, context-aware personalisation, multimodal (text/audio) input, empathetic support, habit-aligned reminders, localised humour, and gamified features such as success stories and knowledge quizzes. Therefore, our study aims to test, via a two-arm non-inferiority randomised controlled trial, the effectiveness of a comprehensive intervention combining brief cessation advice (AWARD), personalised active referral, and this engagement-enhanced GenAI chatbot support compared with human-led instant messaging counselling among current smokers who join the Quit to Win Contest across all 18 districts of Hong Kong.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
998

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Man Ping Wang, PhD
  • Phone Number: +852 3917 6636
  • Email: mpwang@hku.hk

Study Contact Backup

Study Locations

  • Hong Kong
    • Hong Kong
      • Hong Kong, Hong Kong, Hong Kong, 999077
        • Hong Kong Council on Smoking and Health (COSH)
        • Contact:
          • Man Ping Wang, PhD
          • Phone Number: +852 3917 6636
          • Email: mpwang@hku.hk
        • Sub-Investigator:
          • Shengzhi Zhao, PhD
        • Sub-Investigator:
          • Xiaoyun Xie, MPH
        • Sub-Investigator:
          • Mengyao Li, Mphil
        • Contact:
        • Principal Investigator:
          • Man Ping Wang
        • Sub-Investigator:
          • Ziqiu Guo, PhD
        • Sub-Investigator:
          • Yilan Wu, MGH

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Hong Kong residents aged 18 years or above
  2. Smoke at least one cigarette (including heated tobacco products) per day or use an e-cigarette daily in the preceding 3 months
  3. Able to communicate in Cantonese (including reading and writing Chinese)
  4. Saliva cotinine level ≥30 ng/mL
  5. Intention to quit or reduce smoking
  6. Have WhatsApp installed
  7. Able to use WhatsApp for communication

Exclusion Criteria:

Currently participating in other smoking cessation programmes or using any smoking cessation drug

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention group
Behavioral: Reminder messages
WhatsApp messages on follow-up survey reminders.
Behavioral: AWARD advice
A brief (30-60 seconds) face-to-face or remote smoking cessation advice delivered using the validated AWARD model: Ask about smoking history; Warn about high health risks (accompanied by a health warning leaflet); Advise quitting as soon as possible and setting a quit date (to qualify for contest prizes); Refer to smoking cessation services using a referral card; Do it again - repeat the intervention at each follow-up, encouraging re-quitting after relapse or relapse prevention after success.
Behavioral: Brief leaflet on health warning and smoking cessation
A two-sided, colour-printed A4 leaflet covering: (1) absolute risk of death from smoking; (2) full list of diseases caused by active and second-hand smoking; (3) ten pictorial warnings of health consequences on one page for maximum impact; (4) benefits of smoking cessation; and (5) simple encouraging messages to quit.
Behavioral: Referral card
A three-folded card containing brief information and highlights of existing smoking cessation services in Hong Kong, contact methods, motivational messages, and strong supporting slogans.
Behavioral: Self-help smoking cessation booklet
A generic booklet provided covering: benefits of quitting, smoking-related diseases, methods to quit, how to handle withdrawal symptoms, a quitting declaration, and other practical tips.
Behavioral: Personalized active referral
Smokers will be introduced to various SC services in Hong Kong (via the referral card) and motivated to use them. Well-trained SC ambassadors will assist smokers in choosing their favourite or most convenient type of service. Research staff will assist participants in booking or re-booking the SC services at the 1- and 2-month follow-ups (after very brief questionnaire surveys). Participants' contact information will be forwarded to SC service providers within 7 days, and providers are expected to contact participants within 1-2 weeks. Research staff will also monitor participants' use of SC services at each follow-up (1-, 2-, 3-, and 6-month) and assist participants in booking or rebooking appointments if necessary at the 1- and 2-month follow-ups. We shall liaise with the existing service providers and seek their assistance in supporting our smokers in a timely manner.
Behavioral: 12 weeks of chatbot-based instant messaging support
Participants in the intervention group will receive 12 weeks of instant messaging support delivered by an LLM-based chatbot (GPT-4o or newer) on WhatsApp, supporting text and audio input. Using prompt engineering, agent techniques, and Retrieval-Augmented Generation, the chatbot delivers theory-based 5As/5Rs-structured interventions alongside freeform, on-demand support, with engagement features including personalisation, proactive check-ins, and interactive Quick Commands.
Active Comparator: Control group
Behavioral: Reminder messages
WhatsApp messages on follow-up survey reminders.
Behavioral: AWARD advice
A brief (30-60 seconds) face-to-face or remote smoking cessation advice delivered using the validated AWARD model: Ask about smoking history; Warn about high health risks (accompanied by a health warning leaflet); Advise quitting as soon as possible and setting a quit date (to qualify for contest prizes); Refer to smoking cessation services using a referral card; Do it again - repeat the intervention at each follow-up, encouraging re-quitting after relapse or relapse prevention after success.
Behavioral: Brief leaflet on health warning and smoking cessation
A two-sided, colour-printed A4 leaflet covering: (1) absolute risk of death from smoking; (2) full list of diseases caused by active and second-hand smoking; (3) ten pictorial warnings of health consequences on one page for maximum impact; (4) benefits of smoking cessation; and (5) simple encouraging messages to quit.
Behavioral: Referral card
A three-folded card containing brief information and highlights of existing smoking cessation services in Hong Kong, contact methods, motivational messages, and strong supporting slogans.
Behavioral: Self-help smoking cessation booklet
A generic booklet provided covering: benefits of quitting, smoking-related diseases, methods to quit, how to handle withdrawal symptoms, a quitting declaration, and other practical tips.
Behavioral: Personalized active referral
Smokers will be introduced to various SC services in Hong Kong (via the referral card) and motivated to use them. Well-trained SC ambassadors will assist smokers in choosing their favourite or most convenient type of service. Research staff will assist participants in booking or re-booking the SC services at the 1- and 2-month follow-ups (after very brief questionnaire surveys). Participants' contact information will be forwarded to SC service providers within 7 days, and providers are expected to contact participants within 1-2 weeks. Research staff will also monitor participants' use of SC services at each follow-up (1-, 2-, 3-, and 6-month) and assist participants in booking or rebooking appointments if necessary at the 1- and 2-month follow-ups. We shall liaise with the existing service providers and seek their assistance in supporting our smokers in a timely manner.
Behavioral: 12 weeks of human-led instant messaging support
Participants in the control group will receive 12 weeks of instant messaging support delivered by a trained human counsellor via WhatsApp. Using the same theoretical frameworks as the chatbot intervention, the counsellor will provide real-time behavioural and psychosocial support grounded in the 5As/5Rs models, Motivational Interviewing (MI), and evidence-based Behaviour Change Techniques (BCTs). The support will be personalised according to each participant's sociodemographic characteristics, smoking patterns, quit intentions, and plans.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Biochemically validated abstinence
Time Frame: 6-month follow-up
Defined as exhaled CO level <4ppm and saliva cotinine level ≤30 ng/ml
6-month follow-up

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Biochemically validated abstinence
Time Frame: 3-month follow-up
Defined as exhaled CO level <4ppm and saliva cotinine level ≤30 ng/ml
3-month follow-up
Self-reported 7-day point prevalence abstinence
Time Frame: 3- and 6-month follow-ups
Smokers who did not smoke even a puff in the 7 days preceding the follow-up
3- and 6-month follow-ups
Self-reported reduction
Time Frame: 1-, 2-, 3- and 6-month follow-ups
Defined by at least 50% reduction in baseline daily number of cigarettes
1-, 2-, 3- and 6-month follow-ups
Self-reported use of smoking cessation service
Time Frame: 1-, 2-, 3- and 6-month follow-ups
Use of smoking cessation service at 1-, 2-, 3- and 6-month follow-ups.
1-, 2-, 3- and 6-month follow-ups
Prolonged abstinence
Time Frame: 3-month and 6-month follow-ups
Abstinence from smoking for 3 consecutive months at 3-month follow-up, or for 6 consecutive months at 6-month follow-up
3-month and 6-month follow-ups
Quit attempt
Time Frame: 1-, 2-, 3-, and 6-month follow-ups
Abstinence for at least 24 hours
1-, 2-, 3-, and 6-month follow-ups
Post-cessation weight change
Time Frame: 6-month follow-up
Self-reported change in body weight (in kilograms) from baseline to follow-up
6-month follow-up
Self-reported mental health conditions
Time Frame: Baseline and 6-month follow-up
Patient Health Questionnaire-4 (PHQ-4)
Baseline and 6-month follow-up
Self-reported smoking-related health conditions
Time Frame: Baseline and 6-month follow-up
Answer "Yes" to experiencing any smoking-related health condition during smoking cessation or reduction
Baseline and 6-month follow-up
Chatbot user experience
Time Frame: 3-month follow-up
Chatbot Usability Scale
3-month follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
The University of Hong Kong

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Man Ping Wang, The University of Hong Kong

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 20, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 30, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 9, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 9, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 15, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 15, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 9, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • QTW2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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