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Cheng CCW, He WJA, Gouda H, Zhang MJ, Luk TT, Wang MP, Lam TH, Chan SSC, Cheung YTD. Effectiveness of Very Brief Advice on Tobacco Cessation: A Systematic Review and Meta-Analysis. J Gen Intern Med 2024; 39:1721-1734. [PMID: 38696026 PMCID: PMC11255176 DOI: 10.1007/s11606-024-08786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/22/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Very brief advice (VBA; ≤ 3 min) on quitting is practical and scalable during brief medical interactions with patients who smoke. This study aims to synthesize the effectiveness of VBA for smoking cessation and summarize the implementation strategies. METHODS We searched randomized controlled trials aiming at tobacco abstinence and comparing VBA versus no smoking advice or no contact from Medline, Embase, CINAHL, Cochrane Library, PsycInfo databases, six Chinese databases, two trial registries ClinicalTrials.gov and WHO-ICTRP from inception to September 30, 2023. Grading of Recommendations, Assessment, Development, and Evaluations framework was used to assess the certainty of the evidence of the meta-analytic findings. The outcomes were self-reported long-term tobacco abstinence at least 6 months after treatment initiation, earlier than 6 months after treatment initiation, and quit attempts. Effect sizes were computed as risk ratio (RR) with 95% CI using frequentist random-effect models. DATA SYNTHESIS Thirteen randomized controlled trials from 15 articles (n = 26,437) were included. There was moderate-certainty evidence that VBA significantly increased self-reported tobacco abstinence at ≥ 6 months in the adjusted model (adjusted risk ratio ARR 1.17, 95% CI: 1.07-1.27) compared with controls. The sensitivity analysis showed similar results when abstinence was verified by biochemical validation (n = 6 studies, RR 1.53, 95% CI 0.98-2.40). There was high-certainty evidence that VBA significantly increased abstinence at < 6 months (ARR 1.22, 95% CI: 1.01-1.47). Evidence of effect on quit attempts (ARR 1.03, 95% CI 0.97-1.08) was of very low certainty. DISCUSSION VBA delivered in a clinical setting is effective in increasing self-reported tobacco abstinence, which provides support for wider adoption in clinical practice.
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Affiliation(s)
| | - Wan Jia Aaron He
- School of Nursing, the University of Hong Kong, Hong Kong, China
| | - Hebe Gouda
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
- World Health Organization, Geneva, Switzerland
| | - Min Jin Zhang
- School of Nursing, the University of Hong Kong, Hong Kong, China
| | - Tzu Tsun Luk
- School of Nursing, the University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, the University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, the University of Hong Kong, Hong Kong, China
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Gjorgjievski D, Stavrikj K, Jordan R, Adab P, Stanoevski G, Stamenova A, Krstevska E, Simonovska S, Trpcheski F, Adams R, Easter C, Rai K, Cheng KK, Chi C, Cooper BG, Correia-de-Sousa J, Dickens AP, Enocson A, Gale N, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stelmach R, Turner A, Williams S, Farley A. Randomised controlled trial testing effectiveness of feedback about lung age or exhaled CO combined with very brief advice for smoking cessation compared to very brief advice alone in North Macedonia: findings from the Breathe Well group. BMC Public Health 2023; 23:1887. [PMID: 37773124 PMCID: PMC10541684 DOI: 10.1186/s12889-023-16644-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION In 2019, smoking prevalence in North Macedonia was one of the world's highest at around 46% in adults. However, access to smoking cessation treatment is limited and no co-ordinated smoking cessation programmes are provided in primary care. METHODS We conducted a three parallel-armed randomised controlled trial (n = 1368) to investigate effectiveness and cost-effectiveness of lung age (LA) or exhaled carbon monoxide (CO) feedback combined with very brief advice (VBA) to prompt smoking cessation compared with VBA alone, delivered by GPs in primary care in North Macedonia. All participants who decided to attempt to quit smoking were advised about accessing smoking cessation medications and were also offered behavioural support as part of the "ACT" component of VBA. Participants were aged ≥ 35 years, smoked ≥ 10 cigarettes per day, were recruited from 31 GP practices regardless of motivation to quit and were randomised (1:1:1) using a sequence generated before the start of recruitment. The primary outcome was biochemically validated 7-day point prevalence abstinence at 4 weeks (wks). Participants and GPs were not blinded to allocation after randomisation, however outcome assessors were blind to treatment allocation. RESULTS There was no evidence of a difference in biochemically confirmed quitting between intervention and control at 4wks (VBA + LA RR 0.90 (97.5%CI: 0.35, 2.27); VBA + CO RR 1.04 (97.5%CI: 0.44, 2.44)), however the absolute number of quitters was small (VBA + LA 1.6%, VBA + CO 1.8%, VBA 1.8%). A similar lack of effect was observed at 12 and 26wks, apart from in the VBA + LA arm where the point estimate was significant but the confidence intervals were very wide. In both treatment arms, a larger proportion reported a reduction in cigarettes smoked per day at 4wks (VBA + LA 1.30 (1.10, 1.54); VBA + CO 1.23 (1.03, 1.49)) compared with VBA. The point estimates indicated a similar direction of effect at 12wks and 26wks, but differences were not statistically significant. Quantitative process measures indicated high fidelity to the intervention delivery protocols, but low uptake of behavioural and pharmacological support. VBA was the dominant intervention in the health economic analyses. CONCLUSION Overall, there was no evidence that adding LA or CO to VBA increased quit rates. However, a small effect cannot be ruled out as the proportion quitting was low and therefore estimates were imprecise. There was some evidence that participants in the intervention arms were more likely to reduce the amount smoked, at least in the short term. More research is needed to find effective ways to support quitting in settings like North Macedonia where a strong smoking culture persists. TRIAL REGISTRATION The trial was registered at http://www.isrctn.com (ISRCTN54228638) on the 07/09/2018.
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Affiliation(s)
- Dragan Gjorgjievski
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Katarina Stavrikj
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Rachel Jordan
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Gjorgji Stanoevski
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Aleksandra Stamenova
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Emilija Krstevska
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Sara Simonovska
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Fillip Trpcheski
- Centre for Family Medicine, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
| | - Rachel Adams
- Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
| | - Christina Easter
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Kiran Rai
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Chunhua Chi
- Department of General Practice, Peking University First Hospital, Beijing, China
| | | | - Jaime Correia-de-Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Andrew P Dickens
- Observational and Pragmatic research Institute, Midview City, Singapore
| | - Alexandra Enocson
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Nicola Gale
- Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Mariam Maglakelidze
- Petre Shotadze Tbilisi Medical Academy, 51/2 Ketevan Dedofali Ave, Tbilisi, 0144, Georgia
| | - Tamaz Maghlakelidze
- Ivane Javakhishvili Tbilisi State University, 1 Ilia Chavchavadze Avenue, Tbilisi, 0179, Georgia
| | - Sonia Martins
- Family Medicine, ABC Medical School, Sao Paolo, Brazil
| | - Alice Sitch
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Rafael Stelmach
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alice Turner
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Siân Williams
- International Primary Care Respiratory Group, 19 Armour Mews, Larbert, FK5 4FF, Scotland
| | - Amanda Farley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Qiao K, Liu H, Li X, Jin Q, Wang Y, Gu M, Bai X, Qin T, Yang Y. An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial. Front Psychiatry 2023; 14:1029640. [PMID: 36960455 PMCID: PMC10027698 DOI: 10.3389/fpsyt.2023.1029640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Objective To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Methods Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Results Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. Conclusion The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.
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Affiliation(s)
- Kun Qiao
- School of Public Health, Capital Medical University, Beijing, China
| | - Han Liu
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xingming Li
- School of Public Health, Capital Medical University, Beijing, China
- *Correspondence: Xingming Li,
| | - Qianying Jin
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yao Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Mingyu Gu
- School of Public Health, Capital Medical University, Beijing, China
| | - Xinyuan Bai
- School of Public Health, Capital Medical University, Beijing, China
| | - Tingting Qin
- School of Public Health, Capital Medical University, Beijing, China
| | - Yutong Yang
- School of Public Health, Capital Medical University, Beijing, China
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Gao X, Shen F, Li S, Zhang R, Jiang W, Li B, Wang R. The estimated influence of assumed physicians' advice for tobacco smoking cessation among current smokers in Shanghai, China: A cross-sectional study. Tob Induc Dis 2022; 20:86. [PMID: 36317058 PMCID: PMC9574849 DOI: 10.18332/tid/153508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/27/2022] [Accepted: 09/05/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Evidence indicates that physicians' smoking cessation advice is significant for tobacco control, which is an impetus to encourage smoking cessation among smokers, but the estimated influence of physicians' smoking cessation advice on smokers' intention to quit is limited in Shanghai, China. METHODS We enrolled 1104 participants who were current smokers in the SJ (Songjiang) and FX (Fengxian) districts in Shanghai in 2021. An electronic questionnaire was used to collect data and SAS 9.4 was used for data analysis. Univariate and multivariate logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the influence of the assumed physicians' advice for smoking cessation on current smokers' smoking cessation plan. RESULTS A total of 1104 participants provided information of which 914 were male smokers (82.8%) and 190 (17.2%) were female smokers. Multivariate logistic regression demonstrated that female smokers (OR=2.47; 95% CI: 1.66-3.68), smokers with at least 1 type of non-communicable disease (OR=2.09; 95% CI: 1.42-3.07), smoking intensity <20 cigarettes/day (OR=1.64; 95% CI: 1.22-2.17), with personal tobacco burden less than 20% (OR=1.52; 95% CI: 1.10-2.13), exposed to secondhand smoke (OR=1.99; 95% CI:1.44-2.76), and previous smoking cessation attempt (OR=4.43; 95% CI: 3.23-6.08), were more likely to report an intent to quit smoking. Moreover, approximately 50% of participants without a plan to quit in a year had also reported their intention to quit smoking with the presumption that the physicians would advise them to quit, irrespective of their sex, age, NCD status and secondhand tobacco smoke exposure. CONCLUSIONS Physicians' cessation advice could promote smokers to consider stopping smoking. The reported cessation intention was higher among female smokers, and smokers with NCD, lower smoking intensity and burden, with smoking cessation attempts, all of which could be incorporated into the implementation of tobacco control measures in the future in Shanghai.
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Affiliation(s)
- Xiangjin Gao
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fanlingzi Shen
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Zhang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Wencheng Jiang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Bin Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Ruiping Wang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Cheung YTD, Jiang N, Jiang CQ, Zhuang RS, Gao WH, Zhou J, Lu JH, Li H, Wang JF, Lai YS, Sun JS, Wu JC, Ye C, Li N, Zhou G, Chen JY, Ou XY, Liu LQ, Huang ZH, Ho SY, Li HCW, Su SH, Yang Y, Jiang Y, Zhu WH, Yang L, Lin P, He Y, Cheng KK, Lam TH. Physicians' very brief (30-sec) intervention for smoking cessation on 13 671 smokers in China: a pragmatic randomized controlled trial. Addiction 2021; 116:1172-1185. [PMID: 32918512 PMCID: PMC8246886 DOI: 10.1111/add.15262] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/11/2020] [Accepted: 09/02/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Three to 10 minutes of smoking cessation advice by physicians is effective to increase quit rates, but is not routinely practised. We examined the effectiveness of physicians' very brief (approximately 30 sec) smoking cessation intervention on quit rates among Chinese outpatient smokers. DESIGN A pragmatic, open-label, individually randomized controlled trial. SETTING Seventy-two medical outpatient departments of hospitals and/or community health centers in Guangdong, China. PARTICIPANTS Chinese adults who were daily cigarette smokers (n = 13 671, 99% males) were invited by their physician to participate during outpatient consultation. Smokers who were receiving smoking cessation treatment or were judged to need specialist treatment for cessation were excluded. INTERVENTIONS The intervention group (n = 7015) received a 30-sec intervention including physician's very brief advice, a leaflet with graphic warnings and a card with contact information of available cessation services. The control group (n = 6656) received a very brief intervention on consuming vegetables and fruit. A total of 3466 participants in the intervention group were further randomized to receive a brief booster advice from trained study personnel via telephone 1 month following their doctor visit. MEASUREMENTS The primary outcome was self-reported 7-day point prevalence abstinence (PPA) in the intervention and control groups at the 12-month follow-up. Secondary outcomes included self-reported 30-day abstinence and biochemically validated abstinence at 12-month follow-up. FINDINGS By intention-to-treat, the intervention (versus control) group had greater self-reported 7-day abstinence [9.1 versus 7.8%, odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.03-1.26, P = 0.008] and 30-day abstinence (8.0 versus 6.9%, OR = 1.14, 95% CI = 1.03-1.27, P = 0.01) at 12-month follow-up. The effect size increased when only participants who received the intervention from compliant physicians were included (7-day PPA, OR = 1.42, 95% CI = 1.11-1.74). The group difference in biochemically validated abstinence was small (0.8 versus 0.8%, OR = 1.00, 95% CI = 0.71-1.42, P = 0.99). CONCLUSION A 30-sec smoking cessation intervention increased self-reported abstinence among mainly male smokers in China at 12-month follow-up (risk difference = 1.3%), and should be feasible to provide in most settings and delivered by all health-care professionals.
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Affiliation(s)
| | - Nan Jiang
- Department of Population Health, Grossman School of MedicineNew York UniversityNew YorkNYUSA
| | | | - Run Sen Zhuang
- Shenzhen Health Education and Promotion CentreShenzhenChina
| | - Wen Hui Gao
- Shenzhen Health Education and Promotion CentreShenzhenChina
| | - Jian Zhou
- Department of Respiratory MedicineGuangzhou Medical University Second Affiliated HospitalGuangzhouChina
| | - Jin Hong Lu
- Traditional Chinese Medical Hospital of HuangpuGuangzhouChina
| | - Hui Li
- Shenzhen Bao'an District Songgang People's Hospital, Hongqiaotou Community Health Service CenterShenzhenChina
| | - Jun Feng Wang
- The Fifth Affiliated Hospital of Sun Yat‐sen University, ZhongshangChina
| | - Yi Sheng Lai
- Shenzhen Longgang District Central HospitalShenzhenChina
| | - Jun Sheng Sun
- Shenzhen Longgang District Central HospitalShenzhenChina
| | - Jiu Chang Wu
- Shenzhen Bao'an District Fuyong HospitalShenzhenChina
| | - Chiang Ye
- Division of EndocrinologyShenzhen Bao'an District People's HospitalShenzhenChina
| | - Na Li
- Shenzhen Longgang District Central HospitalShenzhenChina
| | - Gang Zhou
- Guangzhou No. 12 HospitalGuangzhou Guangdong ProvinceChina
| | - Jing Ying Chen
- Shenzhen Longgang District Second People's HospitalShenzhenChina
| | - Xiu Yan Ou
- ZhongShan City People's Hospital, ZhongShanChina
| | - Liu Qing Liu
- Longhua District People's Hospital Yansong Community CenterShenzhenChina
| | - Zhuang Hong Huang
- The First Affiliated Hospital of Shantou University Medical College Guan Bu Zhai Mei Healthcare StationShantouChina
| | - Sai Yin Ho
- School of Public HealthThe University of Hong KongHong Kong, China
| | | | - Sheng Hua Su
- Health Care Center for Cadre of Guangdong ProvinceGuangzhouChina
| | - Yan Yang
- Tobacco Control Office, Chinese Center for Disease Control and PreventionChina
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and PreventionChina
| | - Wei Hua Zhu
- Guangzhou No. 12 HospitalGuangzhou Guangdong ProvinceChina
| | - Lie Yang
- Guangzhou No. 12 HospitalGuangzhou Guangdong ProvinceChina
| | - Peiru Lin
- Guangzhou First Municipal People's Hospital, Guangzhou Medical UniversityGuangzhouChina
| | - Yao He
- Institute of Geriatrics, Chinese PLA General HospitalBeijingChina
| | - Kar Keung Cheng
- Institute of Applied Health ResearchUniversity of BirminghamUK
| | - Tai Hing Lam
- School of Public HealthThe University of Hong KongHong Kong, China
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Ho KY, Li WHC, Lam KKW, Wang MP, Xia W, Ho LY, Ho LLK, Lam TH, Chan SSC. Promoting smoking cessation among community-living female smokers by training smoking cessation and reduction ambassadors. J Public Health (Oxf) 2020; 42:53-61. [PMID: 30608601 DOI: 10.1093/pubmed/fdy223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/18/2018] [Accepted: 12/08/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Females are less willing than males to seek help from smoking cessation services; the present study examined how the use of these services by females could be enhanced by training young female ambassadors to deliver a brief intervention. METHODS We collaborated with the Hong Kong Girl Guides Association. Fifty of the association's Girl Guides served as smoking cessation and reduction ambassadors to deliver a brief intervention to at least two female smokers. The effectiveness of the intervention was evaluated by a one-group pre-test and repeated post-test design. We undertook data collection at baseline and at 1, 3 and 6 months. RESULTS In all, 106 female smokers received the brief intervention. At 6-month follow-up, the self-reported abstinence was 12.2%; the biochemically verified prevalence of quitting was 5.7%. Approximately 7% of participants were motivated to use smoking cessation services between baseline and 6 months. CONCLUSIONS This study supports the effectiveness of a brief intervention in promoting smoking cessation for community-living female smokers in Hong Kong. However, the intervention could be enhanced by further promoting the use of smoking cessation services to female smokers.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - William Ho Cheung Li
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Katherine Ka Wai Lam
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Wei Xia
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Lok Yin Ho
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
| | - Sophia Siu Chee Chan
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Zhang L, Chen Y, Lv Y, Yang X, Yin Q, Bai L, Luo Y, Sharma M, Zhao Y. The Perception and Intervention of Internship Nursing Students Helping Smokers to Quit: A Cross-Sectional Study in Chongqing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3882. [PMID: 31614952 PMCID: PMC6843520 DOI: 10.3390/ijerph16203882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023]
Abstract
Background: Smoking is among the most preventable causes of death globally. Tobacco cessation can lessen the number of potential deaths. The China Tobacco Cessation Guidelines encourage medical staff to perform the 5As (Ask, Advise, Assess, Assist, Arrange) when delivering tobacco dependence treatments to patients. Nursing students will develop to be nurses in the future and they have to finish 9 months of clinical practicum study in the last year at hospitals or care centers. However, the frequency of behaviors used to help smokers quit among Chinese nursing internship students is unclear. This study analyzed the rate of nurse interns' performance of the 5As and which demographic characteristics, perceptions of smoking and knowledge predicted higher performance of the 5As. Methods: The cluster sampling method was used to select 13 teaching hospitals among 29. All nursing intern students were expected to finish the questionnaire about their 5As behaviors to help patients quit smoking. Their 5As performances were scored from one to five with 5 being the best and scores were summed. A multivariate linear mixed-effect model was employed to test the differences between their 5As. Results: Participating in the survey were 1358 interns (62.4% response rate). The average scores were as follows-Ask-3.15, Advise-2.75, Assess-2.67, Assist-2.58 and Arrange-2.42. A total of 56.3% students perceived that medical staff should perform the 5As routinely to help patients quit smoking. On the other hand, 52.1% viewed clinical preceptors as role models of the 5As. School education regarding tobacco control, smoking dependence treatment, self-efficacy and positive intentions were predictors of higher performance of the 5As (p < 0.001). Conclusions: Nursing internship students seldom administered tobacco dependence treatments to patients. It is essential to improve the corresponding education, skills and self-efficacy of the 5As. Meanwhile, clinical preceptors should procure more training in the responsibilities and skills related to tobacco cessation. In this way, clinical preceptors can be role models of the 5As and impart positive influences on interns.
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Affiliation(s)
- Li Zhang
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China.
- College of Nursing, Chongqing Medical University, Chongqing 400016, China.
| | - Yanhan Chen
- College of Nursing, Chongqing Medical University, Chongqing 400016, China.
| | - Yalan Lv
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China.
| | - Xia Yang
- College of Nursing, Chongqing Medical University, Chongqing 400016, China.
| | - Qianyu Yin
- College of Nursing, Chongqing Medical University, Chongqing 400016, China.
| | - Li Bai
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China.
| | - Yaling Luo
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China.
| | - Manoj Sharma
- Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
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Akanbi MO, Carroll AJ, Achenbach C, O'Dwyer LC, Jordan N, Hitsman B, Bilaver LA, McHugh MC, Murphy R. The efficacy of smoking cessation interventions in low- and middle-income countries: a systematic review and meta-analysis. Addiction 2019; 114:620-635. [PMID: 30506845 PMCID: PMC6411424 DOI: 10.1111/add.14518] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/27/2018] [Accepted: 11/23/2018] [Indexed: 12/28/2022]
Abstract
AIMS To summarize evidence for the efficacy of smoking cessation interventions in low- and middle-income countries (LMICs). DESIGN Systematic review and meta-analysis of randomized controlled trials. SETTING LMICs as defined by the World Bank. PARTICIPANTS Adult current cigarette smokers residing in LMICs. INTERVENTIONS Behavioral and/or pharmacotherapy smoking cessation interventions. MEASUREMENTS PubMed MEDLINE, EMBASE (embase.com), Cochrane Central Register of Controlled Trials (Wiley), PsycINFO (Ebsco), SciELO, WHO Global Index Medicus and Scopus were searched from inception to 4 April 2018. Only studies with at least 6 months of follow-up were included. We used the most rigorous assessment of abstinence reported by each study. Effect sizes were computed from abstracted data. Where possible, a meta-analysis was performed using Mantel-Haenzel random-effect models reporting odds ratios (OR) and 95% confidence intervals (CI). FINDINGS Twenty-four randomized controlled trials were included. Six investigated the efficacy of pharmacological agents. Four trials that compared nicotine replacement therapy (NRT) to placebo found NRT improved cessation rates (n : NRT 546, control 684, OR = 1.76, 95% CI = 1.30-2.77, P < 0.001, I2 = 13%). Eight trials found that behavioral counseling was more effective than minimal interventions (e.g. brief advice); n : Counseling 2941, control 2794, OR = 6.87, 95% CI = 4.18-11.29, P < 0.001, I2 = 67%). There was also evidence of the benefit of brief advice over usual care (n : Brief advice 373, control 355, OR = 2.46, 95% CI = 1.56-3.88, P < 0.001, I2 = 0%). CONCLUSION Nicotine replacement therapy, behavioral counseling and brief advice appear to be effective in aiding smoking cessation in low- and middle-income countries. There is limited rigorous research on other smoking cessation interventions in these regions.
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Affiliation(s)
- Maxwell Oluwole Akanbi
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
- Center for Global HealthNorthwestern UniversityChicagoILUSA
| | - Allison Jane Carroll
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Chad Achenbach
- Center for Global HealthNorthwestern UniversityChicagoILUSA
- Department of Infectious DiseasesNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Linda Catherine O'Dwyer
- Galter Health Sciences Library and Learning CenterNorthwestern University, Feinberg School of MedicineChicagoILUSA
| | - Neil Jordan
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
- Hines VA HospitalHinesILUSA
| | - Brian Hitsman
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Lucy Ann Bilaver
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Megan Colleen McHugh
- Health Sciences Integrated PhD Program, Center for Education in Health SciencesInstitute for Public Health and Medicine, Northwestern University Feinberg School of MedicineChicagoILUSA
| | - Robert Murphy
- Center for Global HealthNorthwestern UniversityChicagoILUSA
- Department of Infectious DiseasesNorthwestern University Feinberg School of MedicineChicagoILUSA
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9
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Chan SSC, Cheung YTD, Wan Z, Wang MP, Lam TH. Proactive and Brief Smoking Cessation Intervention for Smokers at Outdoor Smoking "Hotspots" in Hong Kong. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:365-370. [PMID: 27474113 DOI: 10.1007/s13187-016-1085-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Increased outdoor smoking is a common phenomenon after indoor smoking bans were in place. A series of observational studies were conducted to evaluate a novel, proactive, and brief smoking cessation intervention at outdoor smoking "hotspots," i.e., outdoor public areas where ashtrays were available and smokers clustered to smoke. The number of smokers at 26 selected hotspots were observed and counted for two consecutive days. Further observations of the smokers' characteristics and brief smoking cessation intervention were conducted at ten of the hotspots with the greatest number of smokers. Responses of the smokers to the brief intervention, including a leaflet and brief smoking cessation advice using AWAR protocol delivered by trained smoking cessation ambassadors, were assessed. A total of 24,034 smokers were observed within 464 h, which equals 51.8 smokers per hour. Of the 5070 pedestrians observed at the ten hotspots during the intervention sessions, 1228 (24.2 %) were smokers. In the 1228 smokers who were approached during our intervention sessions, about two thirds were willing to receive the self-help leaflet on smoking cessation whereas about half received the brief smoking cessation advice. Recruiting smokers and delivering brief smoking cessation interventions at smoking hotspots are feasible and likely effective to reach large numbers of smokers. Studies to evaluate the effectiveness of using this approach for smoking cessation are warranted.
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Affiliation(s)
| | - Yee Tak Derek Cheung
- School of Nursing, The University of Hong Kong, Hong Kong, China.
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - Zoe Wan
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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10
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Wu L, He Y, Jiang B, Zhang D, Tian H, Zuo F, Lam TH. Very brief physician advice and supplemental proactive telephone calls to promote smoking reduction and cessation in Chinese male smokers with no intention to quit: a randomized trial. Addiction 2017. [PMID: 28623848 DOI: 10.1111/add.13908] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS There is inconsistent evidence that behavioural support to promote smoking reduction is effective at increasing smoking cessation. We examined the effectiveness of brief physician advice together with four very brief telephone calls in promoting smoking cessation among Chinese men via reduction compared with equivalent advice on diet and exercise. DESIGN A two-group pragmatic randomized controlled trial. PARTICIPANTS AND SETTING Male patients attending the Endocrinology and Acupuncture out-patient clinics of a general hospital in Beijing, China. INTERVENTION AND COMPARATORS Physicians advised participants allocated to the smoking-reduction intervention (SRI, n = 181) group to reduce smoking to at least half of their current consumption within 1 month at baseline. At follow-up, a telephone counsellor repeated this advice if the participant had not reduced their cigarette consumption. Participants who had reduced consumption were encouraged to quit smoking. Physicians gave participants in the exercise and diet advice (EDA, n = 188) control group brief advice about physical activity and healthy diet at baseline, and a telephone counsellor reinforced this at each follow-up interview. Both groups had one face-to-face interview at baseline plus five telephone interviews and interventions (approximately 1 minute each) at 1 week and 1-, 3-, 6- and 12-month follow-up. MEASUREMENTS The primary outcome was self-reported 6-month prolonged abstinence rate at 12-month follow-up interview. FINDINGS By intention-to-treat, the self-reported 6-month prolonged abstinence rate at 12-month follow-up in the SRI groups (19 quitters, 15.7%) was higher, but not significantly, than the EDA control group (10 quitters, 7.8%), and the adjusted odds ratio (OR) and 95% confidence interval (CI) was 2.26 (0.97-5.26), P = 0.062. The self-reported 7-day point prevalence quit rate (secondary outcome) in the SRI group was significantly higher than the control group at each follow-up interview (at 12-month follow-up: 13.3 versus 6.9%, OR (95% CI) = 2.09 (1.01, 4.34), P = 0.049). CONCLUSIONS A very brief, proactive and low-cost smoking-reduction intervention without medications for Chinese male smokers with no intention to quit appears to increase smoking abstinence.
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Affiliation(s)
- Lei Wu
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Bin Jiang
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Di Zhang
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Hui Tian
- Nanlou Department of Endocrinology, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Fang Zuo
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Tai Hing Lam
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,School of Public Health, The University of Hong Kong, Hong Kong
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11
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Chan SSC, Cheung YTD, Wong YMB, Kwong A, Lai V, Lam TH. A Brief Smoking Cessation Advice by Youth Counselors for the Smokers in the Hong Kong Quit to Win Contest 2010: a Cluster Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 19:209-219. [PMID: 28755244 DOI: 10.1007/s11121-017-0823-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Smoking cessation counseling by healthcare professionals is effective, but very few healthcare professionals can deliver these interventions in the busy clinical settings. This study aimed to evaluate the effectiveness of a brief smoking cessation advice delivered by briefly-trained youth counselors at the enrolment of an incentive-based smoking cessation campaign. The study design was a cluster 2-arm randomized controlled trial of 831 Chinese adult smokers who were recruited in public areas to participate in the Hong Kong Quit to Win Contest 2010. The intervention group (n = 441) received a 5-min quitting advice from the youth counselors, who were mainly undergraduate nursing students, and a 12-page self-help smoking cessation booklet at the enrolment, while the control group (n = 390) only received the same booklet. Biochemically confirmed quitters at 6-month follow-up could join a lucky draw that offered HK$10,000 (US$1282) cash prize to three winners and HK$4000 gift vouchers to the other 10 winners. Primary outcome was self-reported smoking abstinence at 6-month follow-up. By intention-to-treat, the intervention group had a non-significantly higher self-reported (18.4 versus 13.8%, OR = 1.40, 95% CI 0.96-2.04, p = 0.08) and validated quit rate (9.1 versus 6.7%, OR = 1.40, 95% CI 0.84-2.33, p = 0.20) than the control group at 6-month follow-up. The analysis with multiple imputation for missing data also found similar results. We concluded that the brief on-site advice by trained youth counselors had a modest effect on smoking cessation, but the effect was not significant. Future studies with larger sample size and results from higher participation of the biochemical validation to confirm the effectiveness are warranted.
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Affiliation(s)
- Sophia Siu Chee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Yee Man Bonny Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Antonio Kwong
- Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Vienna Lai
- Hong Kong Council on Smoking and Health, Hong Kong, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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12
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Cheung YTD, Wang MP, Li HCW, Kwong A, Lai V, Chan SSC, Lam TH. Effectiveness of a small cash incentive on abstinence and use of cessation aids for adult smokers: A randomized controlled trial. Addict Behav 2017; 66:17-25. [PMID: 27863323 DOI: 10.1016/j.addbeh.2016.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 10/27/2016] [Accepted: 11/08/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Large amount of financial incentive was effective to increase tobacco abstinence, but the effect of small amount is unknown. PURPOSE We evaluated if a small amount of cash incentive (HK$500/US$64) increased abstinence, quit attempt, and use of cessation aids. METHODS A three-armed, block randomized controlled trial recruited 1143 adult daily smokers who participated in the Hong Kong "Quit to Win" Contest. Biochemically validated quitters of the early-informed (n=379, notified about the incentive at 1-week and 1-month follow-up) and the late-informed incentive group (n=385, notified at 3-month follow-up) received the incentive at 3months. The validated quitters of the control group (n=379) received the incentive at 6months without prior notification. All subjects received brief advice, a self-help education card and a 12-page booklet. The outcomes were self-reported 7-day point prevalence of abstinence, quit attempt (intentional abstinence for at least 24h) and use of cessation aids at 3-month follow-up. RESULTS By intention-to-treat, the early-informed group at 3-month follow-up reported a higher rate of quit attempt (no smoking for at least 24h) than the other 2 groups (44.1% vs. 37.4%, Odds ratio (OR)=1.32, 95% CI 1.03-1.69, p=0.03), but they had similar abstinence (9.2% vs. 9.7%, OR=0.95, 95% CI 0.62, 1.45). The early- and late-informed group showed similar quitting outcomes. The early-informed group reported more quit attempts by reading self-help materials than the other 2 groups (31.4% vs. 25.3%, OR=1.56, 95% CI 1.12-2.18, p<0.01). CONCLUSIONS The small cash incentive with early notification increased quit attempt by "self-directed help" but not abstinence. Future financial incentive-based programmes with a larger incentive, accessible quitting resources and encouragement of using existing smoking cessation services are needed.
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Affiliation(s)
- Yee Tak Derek Cheung
- School of Public Health, The University of Hong Kong, Hong Kong; School of Nursing, The University of Hong Kong, Hong Kong.
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong
| | | | | | - Vienna Lai
- Hong Kong Council on Smoking and Health, Hong Kong
| | | | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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13
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Driezen P, Abdullah AS, Quah ACK, Nargis N, Fong GT. Determinants of intentions to quit smoking among adult smokers in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh wave 2 survey. Glob Health Res Policy 2016; 1:11. [PMID: 29202060 PMCID: PMC5693557 DOI: 10.1186/s41256-016-0012-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
Background With about 22 million adult smokers, Bangladesh needs strong measures that would promote smoking cessation. Using data from Wave 2 of the International Tobacco Control (ITC) Survey, this study examined the factors associated with intention to quit smoking among Bangladeshi smokers. Methods Data from Wave 2 of the International Tobacco Control (ITC) Survey in Bangladesh, a face to face survey of adult smokers, were analysed. In the ITC survey, households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Results Of the respondents (N = 2982), most were male (96 %), married (80 %), and Muslim (83 %); 33 % were illiterate and 54 % were aged below 40. Almost two-thirds were from areas outside Dhaka, 78 % smoked cigarettes exclusively; and 36 % had an intention to quit smoking in the future. This study identified several predictors, comparable to other international studies, of intention to quit smoking: area of residence, number of cigarettes smoked daily, previous quit attempt, visiting a doctor in the past, having child aged 5 or below at home, perceived benefit from quitting, being worried about own health, knowledge of SHS, not enjoying smoking and workplace smoking policy. Conclusions These findings suggest that the prevalence of intention to quit smoking is lower among Bangladeshi smokers than those among smokers in developed countries. However, the factors relating to quit intentions among Bangladeshi smokers are comparable to those found in Western countries. Population based tobacco control programs and policies should consider these predictors in the design of interventions to increase quitting among smokers in Bangladesh.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON Canada
| | - Abu S Abdullah
- Global Health Program, Duke Kunshan University, Kunshan, Jiangsu Province 215347 China.,Duke Global Health Institute, Duke University, Durham, NC 27710 USA.,Department of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, 801 Massachusetts Avenue, Crosstown Center (2nd Floor), Boston, MA 02118 USA
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, ON Canada
| | - Nigar Nargis
- Department of Economics, University of Dhaka, Dhaka, Bangladesh.,American Cancer Society, Washington DC, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON Canada.,Ontario Institute for Cancer Research, Toronto, ON Canada
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14
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Mao A, Bottorff JL. A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants. Am J Mens Health 2016; 11:1703-1712. [PMID: 26819181 DOI: 10.1177/1557988315627140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included "Lack of available information on smoking cessation assistance" and "Difficulty in accessing smoking cessation assistance," while cultural barriers included "Denial of physiological addiction to nicotine," "Mistrust in the effectiveness of smoking cessation assistance," "Tendency of self-reliance in solving problems," and "Concern of privacy revelation related to utilization of smoking cessation assistance." The findings revealed Chinese immigrants' unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance.
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Affiliation(s)
- Aimei Mao
- 1 Kiang Wu Nursing College of Macau, Macau, China
| | - Joan L Bottorff
- 2 University of British Columbia, Kelowna, British Columbia, Canada.,3 Australian Catholic University, Melbourne, Australia
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15
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Chan SSC, Wong DCN, Cheung YTD, Leung DYP, Lau L, Lai V, Lam TH. A block randomized controlled trial of a brief smoking cessation counselling and advice through short message service on participants who joined the Quit to Win Contest in Hong Kong. HEALTH EDUCATION RESEARCH 2015; 30:609-621. [PMID: 26116584 PMCID: PMC4817085 DOI: 10.1093/her/cyv023] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 05/26/2015] [Indexed: 06/04/2023]
Abstract
The present trial examined the effectiveness of brief interventions for smokers who joined the Hong Kong Quit to Win Contest to quit smoking. A block randomized controlled trial allocated 1003 adult daily smokers to three groups: (i) The TEL group (n = 338) received a 5-min nurse-led telephone counselling; (ii) The SMS group (n = 335) received eight text messages through mobile phone and (iii) The CONTROL group (n = 330) did not receive the above interventions. Participants with biochemically verified abstinence at 6-month follow-up could receive cash incentive. The primary outcome was the self-reported 7-day point prevalence (PP) of tobacco abstinence at 6-month follow-up. The abstinence rate in the TEL, SMS and CONTROL group was 22.2, 20.6 and 20.3%, respectively (P for TEL versus CONTROL = 0.32; P for SMS versus CONTROL = 0.40). When abstinence at 2-, 6- and 12-month follow-up was modelled simultaneously, the TEL group had a higher abstinence than the CONTROL group (Adjusted OR = 1.38, 95% CI = 1.01-1.88, P = 0 .04). In the Quit to Win Contest, the brief telephone counselling might have increased abstinence, but the text messages had no significant effect. Further studies on intensive intervention and interactive messaging services are warranted.
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Affiliation(s)
| | | | | | - Doris Y P Leung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong and
| | - Lisa Lau
- Hong Kong Council on Smoking and Health, Hong Kong
| | - Vienna Lai
- Hong Kong Council on Smoking and Health, Hong Kong
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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16
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Wu L, He Y, Jiang B, Zhang D, Tian H, Zuo F, Lam TH, Cheung YTD. The effect of a very brief smoking-reduction intervention in smokers who have no intention to quit: study protocol for a randomized controlled trial. BMC Public Health 2015; 15:418. [PMID: 25944023 PMCID: PMC4443634 DOI: 10.1186/s12889-015-1749-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/13/2015] [Indexed: 11/30/2022] Open
Abstract
Background Tobacco use is one of the most common preventable causes of death, but more than half of the Chinese men still use tobacco products. Moreover, 63.6% of Chinese smokers have stated that they would not consider quitting. Specialized and intensive smoking-cessation services are too expensive and passive to have major clinical and public health impacts in developing countries like China. Smoking cessation medications are not covered by medical insurance, and their high price prevents Chinese smokers from using them. Brief interventions are needed to provide cost-effective and timesaving tobacco dependence treatments in China mainland. Methods/design We describe a two-arm randomized controlled trial for smokers who have no intention to quit. The project will be conducted in outpatient clinics at a large hospital in Beijing, China. Both arms include one face-to-face interview plus five follow-up interventions. Each intervention will last approximately one minute. Subjects allocated to the smoking-reduction intervention arm (SRI) will be advised to reduce smoking consumption to at least half of their current consumption level within the next month. All subjects in the SRI will be warned to bear in mind that an attempt to reduce smoking is an intermediate step before complete cessation. Smokers who have successfully reduced their smoking consumption will be encouraged to completely cease smoking. Controls are subjects allocated to the exercise- and diet-advice arm (EDA) and will be given advice about healthy diet and physical activity, but the advice will not include smoking cessation or reduction. Data collection will be done at baseline and at each follow-up interview using standardized questionnaires. The primary outcomes include self-reported and biochemically verified 7-day point prevalence and prolonged abstinence rates at 12-month follow-up. Discussion We expect that an intention to quit in smoking outpatients can be motivated by physicians in the clinic setting. If this very brief smoking-reduction intervention can be demonstrated to have a positive impact on long-term smoking cessation, this strategy has the potential to be a viable and acceptable approach and may be used widely in China and elsewhere. Clinical trial registration ClinicalTrials.gov: NCT02370147 (date of registration: 23th February, 2015).
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Affiliation(s)
- Lei Wu
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Bin Jiang
- Department of Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Di Zhang
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Hui Tian
- Department of Endocrinology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Fang Zuo
- Department of Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Yee Tak Derek Cheung
- School of Public Health, Li Ka Shang Faculty of Medicine, The University of Hong Kong, 5/F William MW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pok Fu Lam, Hong Kong.
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