Smoking Cessation
Conditions
Keywords
Smoking cessation, Quit to Win, Brief intervention, Personalized active referral, Instant messaging, SMS, Smoking Cessation Intervention
Brief summary
The present study will examine (1) the effectiveness of personalised active referral to smoking cessation (SC) services and text messaging on encouraging SC services (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.
Detailed description
Although smoking prevalence is decreasing in Hong Kong, there are still 641,300 daily smokers (10.5%; Census and Statistics Department, 2015) and half will be killed by smoking (Lam, 2012) which accounts for over 7,000 deaths per year (Lam, Ho, Hedley, Mak, & Peto, 2001). Smoking also accounts for a large amount of medical cost, long-term care and productivity loss of US$688 million (0.6% Hong Kong GDP) (Census & Statistics Department, 2001; McGhee et al., 2006) . Smoking is a highly addictive behavior and it is difficult for smokers with strong nicotine dependence to quit without assistance. On the other hand, reaching and helping the many smokers who have no intention to quit is a challenge, because they are unlikely to seek professional help from smoking cessation services. The Quit and Win programme provides an opportunity to reach and encourage a large group of smokers to make quit attempt and maintain abstinence. The Quit and Win model posits that smokers participating in the contest will have higher motivation to quit with incentives and better social support (Cahill & Perera, 2011). Studies have found that such quitting contests or incentive programs appeared to reach a large number of smokers and demonstrated a significantly higher quit rate for the quit and win group than for the control group (Cahill & Perera, 2015). Smoking cessation services in Hong Kong are under-used with most of the adult daily smokers (79.6%) who had never used smoking cessation services (Census and Statistics Department, 2015). Among these smokers, only 2.4% were willing to use the services. Our previous RCT in previous QTW Contest 2015 evaluated the effects of low-intensity active referral (LAR) vs. very brief general SC advice (VBA) on quitting. LAR included onsite AWARD counselling and collection of smokers' personal contact information for SC services providers to connect with the smokers. Findings at 3-month follow-up of this RCT suggested the LAR intervention resulted in significantly higher self-reported quit rate than VBA in the control group (18.7% vs 14.0%. P\<0.001). It is warranted to evaluate if a higher intensity active referral (HAR) and/or text messaging on encouraging SC services use can achieve even higher quit rate when compared with only VBA is given in the control group. Noted the use of text-messaging is the cheaper method than HAR. By using the same design of control group in QTW 2015, we can combine and compare the 2 years QTW intervention of HAR, LAR and text-messaging using network meta-analysis. This will contribute to finding out a more cost-effective way to increase the quit rate through using SC services. Therefore, the present study will examine (1) the effectiveness of personalised active referral to smoking cessation (SC) services and text messaging on encouraging SC services (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.
Interventions
BEHAVIORALBrief advice
Very brief, minimal and general smoking cessation advice
OTHER12-page booklet
12-page smoking cessation self-help booklet
OTHERReferral card
The 3-folded Smoking Cessation Services card consists of brief information and highlights of existing smoking cessation services, contact methods, motivation information and strong supporting messages or slogans.
BEHAVIORALHAR
Smokers will be introduced to various smoking cessation (SC) services in Hong Kong (using the referral card) and be motivated to use the services. Field research staff will assist on-site booking SC services for smokers. Tailored messages, including: harm of smoking, benefit of smoking cessation, importance of adherence to smoking cessation appointment and encouragement on abstinence will be sent via instant messaging (IM) services (e.g. WhatsApp, WeChat) to smokers after initial contact.
BEHAVIORALLTM
Fix-schedule SMS messages will be sent to encourage them to book the smoking cessation services appointment. Smokers are required to book the SC appointments by themselves.
BEHAVIORALAWARD
Ask about smoking history, Warn about the high risk of smoking, Advise to quit as soon as possible, Refer to the smoking cessation services, and Do it again: to repeat the intervention during tel. follow-ups.
OTHERA4 leaflet
The 2-side color printed A4 leaflet, which systematically covers the most important messages to motivate smoking cessation
Sponsors
Hong Kong Council on Smoking and Health
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Hong Kong residents aged 18 or above * Smoke at least 1 cigarette per day in the past 3 months * Able to communicate in Cantonese * Exhaled carbon monoxide (CO) 4 ppm or above, assessed by a validated CO smokerlyzer * Have Intention to quit / reduce smoking
Exclusion criteria
* Smokers who have difficulties (either physical or cognitive condition) to communicate * Currently following other smoking cessation programs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| smoking quit rate change from baseline at 3-month follow-up | 3-month follow-up | The primary outcomes are self-reported 7-day point prevalence (pp) quit rate at 3 month among the three groups |
| smoking quit rate change from baseline at 6-month follow-up | 6-month follow-up | The primary outcomes are self-reported 7-day point prevalence (pp) quit rate at 3 month among the three groups |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Smoking reduction rate change from baseline at 6-month follow-up | 6-month follow-up | rate of smoking reduction by at least half of baseline amount in the three groups |
| Smoking quit attempt change from baseline at 3-month follow-up | 3-month follow-up | number of quit attempts at 3 month among the three groups |
| Smoking quit attempt change from baseline at 6-month follow-up | 6-month follow-up | number of quit attempts at 6 month among the three groups |
| Biochemical validated quit rate | 3-month follow-up | biochemically validated quit rates at 3 month in the three groups |
| Reduction rate for all subjects change from baseline at 3- and 6-month follow-up | 3 and 6 months follow-up | the above cessation and reduction outcomes of all subjects participating in Quit to Win contest 2016 |
| Use of smoking cessation service | 3 and 6 months follow-up | use of smoking cessation at 3 and 6 month follow-up among three groups |
| Use of smoking cessation service for all subjects | 3 and 6 months follow-up | Use of smoking cessation service for all subjects participating in Quit to Win contest 2016 |
| quit rate for all subjects change from baseline at 3- and 6-month follow-up | 3 and 6 months follow-up | the above cessation and reduction outcomes of all subjects participating in Quit to Win contest 2016 |
| Smoking reduction rate change from baseline at 3-month follow-up | 3-month follow-up | rate of smoking reduction by at least half of baseline amount in the three groups |
Countries
China
Outcome results
None listed