Initial experiences of an english-speaking digital assistant for tobacco cessation in India

The WHO tobacco control team established the Access Initiative for Quitting Tobacco (AIQT) in July 2020. The AIQT team developed a virtual assistant "Florence" to provide digital counseling services to people willing to quit tobacco.

To assess tobacco users' experience of using WHO digital health assistant "Florence" and to track their behavior changes.

The study was conducted at a tertiary care Teaching Hospital in Delhi-NCR, India from November 2021 to March 2022. A total of 102 English-speaking tobacco users were enrolled through snowballing and online requests to use Florence (https://www.who.int/campaigns/Florence), once at baseline, and pursue as often as they wish during the next three months. A predesigned WHO questionnaire (Florence Introductory Questionnaire and Florence User Follow-up Questionnaire) was used to assess participants' experiences of using Florence and track changes in tobacco use behavior at follow-up. Statistical analysis was performed through SPSS-22 using appropriate frequency distribution parameters and nonparametric tests to assess acceptance and efficacy of Florence.

Most participants at baseline, over 3-5 minutes, felt that Florence could not understand their speech (48%), and needed improvement in advice and information on quitting and tobacco use (52%) but felt comfortable interacting with Florence (42.2%). However, participants who re-visited Florence during the next 3 months (12/102) agreed that Florence helped them make a quit plan and used the recommended toll-free quit (9/12). Overall, there was a significant increase in proportion of participants who did not consume tobacco in the last 07 days after using Florence (09 versus 25 of 102, P < 0.01) and made quit plans (07 versus 15 of 102, P < 0.01) compared to baseline.

Considering the ease, accessibility, and amount of time spent with this virtual assistant, Florence appears a positive step forward in tobacco cessation.