Effectiveness of quit smoking motivation with carbon monoxide feedback module (COQUIT) among college smoker in Selangor

The feedback mechanism consists of expired carbon monoxide measurement result using mobile phone application. The iCO Smokelyzer (Bedfront Scientific Ltd., Rochester, UK) will be used to measure the carbon monoxide level. First, the participant carbon monoxide level will be measured on one to one basis. The CO reading will be record directly into the iPad together with explained feedback about the result interpretation. For each test, a disposable cardboard and alcohol-free wipes will be used to clean the device for disinfection procedure. The result of the CO will be emailed to the participants. The measurement of the expired carbon monoxide will be done by the principal investigator. The feedback of the measurement to the smokers to increase their motivation for intention to quit smoking. . The brief advice consists of motivational intervention based on “5 R’s”; relevance, risks, rewards, roadblocks, and repetition. This 5R’s was based on the National Clinical Practice Guidelines as described below. The brief motivation will be delivered by the trained counsellor on a one to one basis. The 5R motivational intervention will consist of 10 minutes of intervention based on the module from Ministry of Health (MOH) manual for quit smoking clinic. The 5R theme are as below: Relevance • Encourage the patient to indicate why quitting is personally relevant, being as specific as possible. Motivational information has the greatest impact if it is relevant to a patient’s disease status or risk, family or social situation (e.g. having children in home) Risks • The staff will as the patient to identify potential negative consequences of tobacco use. The staff may suggest and highlight those that seem most relevant to the patient. The staff will emphasize that switching to low-tar/low nicotine cigarette or other forms of tobacco will still have similar risks. Example of risks are: Short-term risks: Shortness of breath, exacerbation of asthma, harm to pregnancy, impotence, infertility, increased serum carbon monoxide. Rewards • The staff will ask the patient to identify potential benefits of stopping tobacco use. The staff may suggest and highlight those that seem most relevant to the patient. Examples of rewards follow such as improved health, save money, feel better about yourself and not worry about exposing others to smoke. Roadblocks • The staff will ask the patient to identify barriers to quitting and note elements of treatment (problem solving, pharmacotherapy) that could address barriers. Typical barriers might include: withdrawal symptoms, fear of failure and weight gain. Repetition • The motivational intervention should be repeated every time an unmotivated patient visits the counsellor. Tobacco users who have failed in previous quit attempts should be told that most people make repeated quit attempts before they are successful. The 5R Motivational module will be given together with the carbon monoxide feedback module. To ensure adherence to the intervention the college administrator will ask to ensure students participation in the program. The control group will only received the 5R motivational module only without the carbon monoxide feedback module.