Tobacco Smoking
Conditions
Keywords
cessation, tobacco, behavioural economics, nudge, opt-out
Brief summary
The goal of this clinical trial is to test the effectiveness of brief behavioural economic intervention in promoting smoking cessation among smokers in the community.
Detailed description
Smoking cessation services are free and effective but underused in Hong Kong. Active referral to smoking cessation services has consistently been found effective in promoting service use and successful quitting as a stand-alone strategy or when combined with other interventions. Participants who received active referral are introduced about the cessation services in Hong Kong and offered connection to the services of their choices. Contacts of participants who agreed to be referred are transferred to the selected cessation providers, who will subsequently contact the participants for further treatment. The current active referral intervention uses an opt-in approach, where participants are required to actively choose to be connected to the services. By leveraging behavioural economic principles, a simple yet promising strategy to strengthen the active referral intervention is to utilize an opt-out approach, where participants are automatically referred to the service unless they actively decline the referral. By making referral to smoking cessation services as the default choice, the investigators aim to increase the uptake of these services and thus improve smoking cessation outcomes. Additionally, mobile messaging informed by behavioural economics principles can serve as nudges to prompt smokers to initiate quitting and utilise cessation services. The clinical trial aims to test the effectiveness of opt-out referral, with or without behavioural economic-based mobile messaging, compared to opt-in referral, in promoting smoking cessation. The trial will be nested within the 15th Quit to Win Smoke-free Community Campaign organised by the Hong Kong Council on Smoking and Health.
Interventions
BEHAVIORALBrief cessation advice
Participants will receive brief cessation advice following the AWARD (ask, warn, advise, refer, do-it-again) model: A: Ask about the tobacco use status; W: Warn about the hazards of tobacco use; A: Advise the smokers to quit; R: Refer the smokers to cessation services; D: Do-it-again
BEHAVIORALOpt-out active referral
Participants will be automatically referred to a smoking cessation service upon joining the trial, unless they choose to opt out. Contacts of participants will be delivered to a service provider of their choice or based on their living district and preferred treatment modality
BEHAVIORALBehavioral economic mobile messaging
Participants will receive behavioural economics-informed messages via mobile instant messaging for 3 months
BEHAVIORALOpt-in active referral
Participants will be offered a referral to a smoking cessation service. Contacts of participants who opt-in will be delivered to a service provider of their choice
Sponsors
Hong Kong Council on Smoking and Health
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Hong Kong residents aged 18 years or above 2. Smoke cigarette or heated tobacco product or e-cigarette daily in the past 3 months 3. Exhaled carbon monoxide level ≥4 parts per million or a positive salivary cotinine test 4. Able to communicate in and read Chinese 5. Own a smartphone with a mobile instant messaging app installed
Exclusion criteria
* Participating in another smoking cessation programme or using any smoking cessation drug or nicotine replacement therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Biochemically validated tobacco abstinence | 6 months after randomisation | Verified by an exhaled carbon monoxide level of \<4 parts per million and a negative salivary cotinine test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Biochemically validated tobacco abstinence | 3 months after randomisation | Verified by an exhaled carbon monoxide level of \<4 parts per million and a negative salivary cotinine test |
| Self-reported 7-day point-prevalence tobacco abstinence | 3 months after randomisation | Tobacco abstinence in the past 7 days |
| Self-reported 24-hour quit attempt | 3 months after randomisation | Tobacco abstinence for at least 24 hours |
| Self-reported use of smoking cessation service | 3 months after randomisation | Use of any smoking cessation service during the follow-up period |
Other
| Measure | Time frame | Description |
|---|---|---|
| Self-reported reduction of tobacco consumption | 3 months after randomisation | Smoking reduction by at least half of the baseline daily number of cigarettes |
Countries
Hong Kong
Contacts
Primary ContactTzu Tsun Luk, PhD, RN
Outcome results
None listed