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Identifying Behavior Change Techniques for Digital Interventions Addressing Alcohol and Tobacco Co-Use: Findings From

Anuijan Chandran1,2, Scott Veldhuizen1,3,4, Kamna Mehra1

  • 1INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada.

JMIR Formative Research
|July 3, 2026
PubMed
Summary

Digital interventions can help reduce alcohol and tobacco use. Six key behavior change techniques (BCTs) like goal setting and feedback were identified as effective for a one-time, self-guided digital intervention.

Keywords:
Delphi studyalcoholbehavior change techniquescessationreductiontobacco

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Area of Science:

  • Behavioral science
  • Digital health
  • Public health

Background:

  • Co-occurring alcohol and tobacco use present a significant global health burden.
  • Integrated interventions are beneficial but face clinical delivery challenges.
  • Digital health interventions offer a scalable solution to support behavior change.

Purpose of the Study:

  • To identify expert consensus on effective behavior change techniques (BCTs) for digital interventions.
  • To determine BCTs suitable for a one-time, self-guided digital tool for alcohol reduction in smokers.
  • To ensure interventions are evidence-based and contextually appropriate.

Main Methods:

  • A 2-round modified Delphi study involving 14 experts.
  • Panelists rated 20 BCTs using the APEASE criteria (acceptability, practicability, effectiveness, affordability, safety, equity).
  • BCTs required 70% expert agreement on all criteria to be deemed appropriate.

Main Results:

  • Six BCTs were identified as appropriate: goal setting, action planning (individualized change plan and reduction strategies), feedback on behavior, reattribution, and pros and cons.
  • These BCTs support behavior change through structured planning and personalized strategies.
  • Eight BCTs were deemed inappropriate for a one-time, unsupervised digital intervention.

Conclusions:

  • Expert consensus was reached on key BCTs for a digital intervention targeting co-occurring alcohol and tobacco use.
  • The identified BCTs are perceived as appropriate and feasible for a one-time, self-guided digital format.
  • This provides a foundation for developing evidence-based digital tools for behavior change.