A Qualitative Study of the Efficacy of Physical Activity Consultation as an Adjunct to Standard Smoking Cessation Treatment in the Context of Malaysia

The intervention is a combination of the standard smoking cessation treatment in Malaysia and Physical Activity Consultation (PAC). PAC is a customized intervention that combines a number of techniques supported by research, including motivational interviewing, self-efficacy theory, including mastery goal setting, the Transtheoretical Model of Behaviour Change and relapse prevention. In this study, the PAC aimed to increase physical activity among smokers trying to quit smoking. Smoking cessation consultation sessions were provided by a nurse with a counselling licence approved by the Malaysian Board of Counsellors. The nurse gave participants behavioural counselling and nicotine replacement therapy in the form of varenicline (Champix). Participants attended the clinic after one week for follow-up. Subsequent visits were scheduled by the clinic nurse depending on participants’ needs. These consultation sessions were conducted as often as needed by the participants until they were successfully abstinent. Smokers who attended the clinic for the first time to seek smoking cessation treatment were invited to participate in the study. They were approached one week after their first smoking cessation consultation. This ensured participants established their smoking cessation program before starting another intervention. PAC was conducted by a facilitator who maintained contact with participants for 21 weeks. PAC consisted of one face-to-face consultation session which lasted for 30 to 40 minutes and two follow-up phone sessions which lasted between 15 to 20 minutes. In the face-to-face consultation, we sought to understand participants’ level of physical activity, general view on physical activity, provide motivation and help them shape their own path for change, at the same time providing them with a sense of autonomy. We assessed participants for their current stage of change and advised on physical activity to suit their current fitness levels. Advice also covered realistic goal setting and relapse prevention. Phone calls at Weeks 3 and 6 functioned as follow-ups with participants on their progress, as well as providing encouragement and motivation. The phone calls were also strategies to help monitor adherence. The intervention ended at Week 8 and follow up interviews (post-intervention) were conducted at Week 9 and Week 21.