Tales of hope and hesitation: Smoking cessation experts' views on the opportunities and risks of digital behaviour change interventions

Digit Health. 2025 Feb 23:11:20552076251322060. doi: 10.1177/20552076251322060. eCollection 2025 Jan-Dec.

Abstract

Objective: Smoking remains a global health challenge, with 1.14 billion active smokers worldwide. Many of these smokers seek cessation support. The rise of mHealth offers novel intervention methods, providing monitoring and tailored feedback. This study aimed to map the opportunities and challenges of integrating digital behaviour change interventions (mHealth) into smoking cessation practices by understanding professionals' perceptions of these tools.

Methods: A qualitative study was conducted involving semi-structured interviews with 11 experienced smoking cessation professionals in Flanders, Belgium. Data collection occurred between January and April 2023. Inductive thematic analysis was performed to identify key patterns and themes in the experts' views regarding mHealth interventions.

Results: The analysis revealed four primary themes: (1) The Inexorable March of Technology - experts acknowledged the inevitability of technology in smoking cessation but varied in enthusiasm; (2) The Shimmering Mirage of Possibility - technology was viewed as supplementary, offering efficiency and support but limited in depth; (3) The Footnotes to Enthusiasm - experts expressed concerns over privacy, inclusivity, and the potential for technology to displace human care; and (4) The Human Anchor - the irreplaceable role of human connection and therapeutic alliance, which digital tools might not be able to replicate.

Conclusion: Experts believe mHealth interventions can augment smoking cessation support but should not replace human-driven care. A blended approach, integrating digital tools with traditional therapeutic relationships, offers the most promise. Addressing concerns about privacy, inclusivity, and most importantly the limits of digital therapeutic alliances is essential for successful mHealth implementation in smoking cessation.

Keywords: behaviour change technology; digital therapeutic alliance; expert perspectives; mHealth interventions; smoking cessation.