Development of a Virtual Human for Supporting Tobacco Cessation During the COVID-19 Pandemic

• Published in: Journal of medical Internet research Vol. 25; no. 1; p. e42310
• Main Authors: Loveys, Kate, Lloyd, Erica, Sagar, Mark, Broadbent, Elizabeth
• Format: Journal Article
• Language: English
• Published: Canada Journal of Medical Internet Research 05.12.2023; Gunther Eysenbach MD MPH, Associate Professor; JMIR Publications
• Subjects: Access; Artificial intelligence; COVID-19; COVID-19 - prevention & control; Disease prevention; Efficacy; Epidemics; Feasibility; Female; Formative evaluation; Health literacy; Humans; Innovations; Intelligence; Intervention; Pandemics; Pandemics - prevention & control; Public health; Severe acute respiratory syndrome coronavirus 2; Smartphones; Smoking Cessation; Smoking cessation programs; Social support; Tobacco; Tobacco Use Cessation; Tobacco Use Disorder; Viewpoint; Young adults; United States > US; chatbot; web-based health; virtual health worker; AI; artificial intelligence; eHealth; conversational agent; COVID-19; tobacco cessation; digital health intervention; smoking cessation; mobile phone; virtual human; public health
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/42310

People who consume tobacco are at greater risk of developing severe COVID-19. Unfortunately, the COVID-19 pandemic reduced the accessibility of tobacco cessation services as a result of necessary social restrictions. Innovations were urgently needed to support tobacco cessation during the pandemic. Virtual humans are artificially intelligent computer agents with a realistic, humanlike appearance. Virtual humans could be a scalable and engaging way to deliver tobacco cessation information and support. Florence, a virtual human health worker, was developed in collaboration with the World Health Organization to remotely support people toward tobacco cessation during the COVID-19 pandemic. Florence delivers evidence-based information, assists with making quit plans, and directs people to World Health Organization–recommended cessation services in their country. In this viewpoint, we describe the process of developing Florence. The development was influenced by a formative evaluation of data from 115 early users of Florence from 49 countries. In general, Florence was positively perceived; however, changes were requested to aspects of her design and content. In addition, areas for new content were identified (eg, for nonsmoker support persons). Virtual health workers could expand the reach of evidence-based tobacco cessation information and personalized support. However, as they are a new innovation in tobacco cessation, their efficacy, feasibility, and acceptability in this application needs to be evaluated, including in diverse populations.