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Enhancing Detection of Message Intents in a Mobile Health Smoking-Cessation Intervention Using Large Language Model
Shagoto Rahman1, Cornelia Connie Pechmann2, Ian G Harris1
1Department of Computer Science, University of California, Irvine, Irvine, CA, 92697, United States, 1 9492334120.
Journal of Medical Internet Research
|March 11, 2026
Summary
Fine-tuning large language models (LLMs) significantly improves intent detection for smoking cessation chatbots. Addressing imbalanced data through downsampling enhanced performance, showing LLMs
Area of Science:
- Artificial Intelligence
- Natural Language Processing
- Digital Health Interventions
Background:
- Low quit rates persist despite smoking-cessation aids like support groups and nicotine replacement therapy (NRT).
- Mobile health interventions offer accessibility but require timely responses, making accurate intent detection crucial for chatbots.
- Large language models (LLMs) show promise for intent detection but struggle with complex language and imbalanced datasets.
Purpose of the Study:
- To develop and evaluate an AI tool using LLMs for accurate intent detection in smoking-cessation messages.
- To address challenges of dataset imbalance and complexity in user messages from a smoking-cessation support group intervention.
Main Methods:
- Utilized the Llama-3 8B LLM, initially off-the-shelf.
- Fine-tuned the LLM on an annotated dataset with 25 intent categories.
- Implemented data downsampling to mitigate bias from predominant intent categories and explored error correction in human annotations.
Main Results:
- Off-the-shelf LLM performance was poor (F1-scores 0.29-0.41).
- Fine-tuning significantly improved performance (F1-scores 0.72-0.86).
- Fine-tuning combined with downsampling and error correction achieved high F1-scores (0.86-0.90) on a corrected dataset, though performance varied on the full dataset.
Conclusions:
- Domain-specific fine-tuning is essential for LLM performance in smoking cessation.
- Dataset imbalance negatively impacts LLM accuracy, with downsampling offering moderate improvements.
- While error correction can refine annotations, automated downsampling may be a more efficient strategy for improving intent detection.

