Smoking Clinical Trial
Official title:
Effectiveness of a Brief, Self-determination Intervention for Smoking Cessation (Immediate or Progressive) Among People Attending Emergency Departments: a Randomised Controlled Trial
The purpose of this study is to test the effectiveness of using a brief, self-determination intervention on smoking cessation (immediate or progressive) for people attending AEDs.
Cigarette smoking, which causes serious damage to health resulting in many chronic problems
including cancer, heart disease, stroke and lung disease, is the single most important,
preventable cause of death and diseases. It is therefore crucial that healthcare
professionals should promote smoking cessation and help patients quit. The Hong Kong
government and community have put enormous efforts on raising tobacco tax, smoke-free
legislation, law enforcement, health promotion campaigns and smoking cessation services. The
prevalence of daily cigarette smokers has been decreasing from 23.3% in 1982 to 10.7 % in
2012, which is one of the lowest around the world. Nevertheless, about half of the smokers
remain reluctant to even try giving up smoking.
Medical attention at Accident and Emergency Departments (AEDs) of smokers who are in physical
discomfort can be developed as an excellent "teachable model" as it provides an invaluable
opportunity to initiate smoking cessation. Smokers consulting doctors as an emergency are
more liable to change their habits to improve their health. According to the Hospital
Authority, about 2 million people attend AEDs in Hong Kong each year, of whom 68% are triaged
as semi-urgent (level 4) and non-urgent (level 5). The average waiting time for a medical
consultation varies among AEDs, but is generally longer than 30 min for triage level 4 and
1-2 h for level 5 - presenting healthcare professionals with a golden opportunity to advise
smokers to quit and on the available smoking cessation programmes while they are waiting.
However, most of the cessation programmes, including stage-matched interventions, generally
take several to more than 30 minutes to implement and hence are not practicable or feasible
in busy clinical settings. Indeed, the most common reason cited by healthcare professionals
for being unable to help patients to quit smoking is the lack of time, because they are very
busy and cannot spare even a few extra minutes to do so. Other barriers include a lack of
training and experience, a lack of confidence in the effectiveness of the interventions, and
the absence of incentives and deficiencies in support or requirements by hospital management
that these programmes should be implemented. Moreover, our previous smoking cessation
projects in outpatient clinics have revealed that many patients are too impatient to undergo
a long intervention and some are reluctant to participate for fear that they might miss or
experience delays in their medical consultation or other medical procedures. To address such
problems, further studies are warranted to develop brief and effective interventions with
simple, direct, strong, evidence-based warnings for patients who smoke.
Smoking is addictive and quitting is very difficult, with a high rate of relapse,
particularly among those with high nicotine dependency. Our previous smoking cessation
projects in outpatient clinics and the community have revealed that many smokers who are
reluctant to quit are interested in reducing the number of cigarettes smoked per day.
Therefore, another potential option would be to help smokers to reduce the number of
cigarettes smoked gradually, with the ultimate goal of complete cessation. Several randomised
controlled trials in the West have supported that smoking reduction interventions can help
smokers first reduce and eventually quit smoking.
What investigators have achieved to date:
Investigators conducted a 'proof-of-principle' pilot randomised controlled trial on a very
brief (<30 s) smoking cessation intervention with a 'one in two smokers will be killed by
smoking' warning in medical outpatient clinics in Guangzhou. The results showed that more of
the smokers who received this brief advice quit or reduced their smoking than did not. This
pilot study suggested that even a very brief intervention on smoking cessation is better than
no advice in the 'real world' practice for outpatient clinics. Moreover, the study
demonstrated the feasibility and acceptability of the implementation of a very brief smoking
cessation programme by healthcare professionals in busy clinical settings. In addition, the
findings support the need for large randomised controlled trials of brief or minimal
interventions with the 'one in two' warning.
In light of the above purpose, investigators designed a study with an experimental
intervention for smoking cessation and a placebo comparator to act as control. Smokers
randomly assigned to the intervention group were given a very brief (<30 s) smoking cessation
intervention during telephone follow-ups with a 'one in two smokers will be killed by
smoking' warning, and a self-help quitting leaflet published by the Hong Kong Council on
Smoking and Health plus a series of brief interventions using the AWARD model. Whereas
smokers randomly assigned to the placebo control group were given a 'placebo' intervention
with a 'placebo booster' during telephone follow-ups (that had the same duration as the
intervention), except that the content was about increasing physical activity and fruit and
vegetable intake.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03999411 -
Smartphone Intervention for Smoking Cessation and Improving Adherence to Treatment Among HIV Patients
|
Phase 4 | |
Completed |
NCT03931772 -
Online Automated Self-Hypnosis Program
|
N/A | |
Completed |
NCT02649556 -
A 26-week Extension of the ZRHR-ERS-09-US Study Evaluating Biological and Functional Changes in Healthy Smokers After Switching to THS 2.2
|
N/A | |
Completed |
NCT03901066 -
Smoking Dependence and Periodontitis
|
||
Recruiting |
NCT05846841 -
Personalized Tobacco Treatment in Primary Care (MOTIVATE)
|
N/A | |
Completed |
NCT03170752 -
Implementing and Testing a Cardiovascular Assessment Screening Program (CASP)
|
N/A | |
Completed |
NCT03305978 -
Pulmonary Nodule Detection: Comparison of an Ultra Low Dose vs Standard Scan.
|
N/A | |
Completed |
NCT00000437 -
Tobacco Dependence in Alcoholism Treatment (Nicotine Patch/Naltrexone)
|
Phase 4 | |
Completed |
NCT06105424 -
BRP1602: Evaluation of Technical and Logistical Feasibility to Measure Lung Permeability
|
N/A | |
Active, not recruiting |
NCT02752022 -
Monitoring the Transition From Smoking to E-cigarettes
|
||
Completed |
NCT02901171 -
The Contribution of a Smartphone Application to Acceptance and Commitment Therapy Group Treatment for Smoking Cessation
|
N/A | |
Completed |
NCT04340830 -
The Effect of Smoking on Dimensional Changes of Free Gingival Graft Around Dental Implants
|
N/A | |
Completed |
NCT02912000 -
TEACH: Technology Evaluation to Address Child Health
|
N/A | |
Completed |
NCT03206619 -
A Health Recommeder System to Tailor Message Preferences in a Smoking Cessation Programme
|
||
Completed |
NCT02949648 -
Electronic Cigarette Use and Quitting in Youth
|
N/A | |
Completed |
NCT02945371 -
Tailored Inhibitory Control Training to Reverse EA-linked Deficits in Mid-life
|
N/A | |
Completed |
NCT02246114 -
Self-Monitoring of Carbon Monoxide to Enhance Reproductive Outcomes in Women
|
N/A | |
Completed |
NCT01898507 -
Nicotine Metabolism and Low Nicotine Cigarettes
|
N/A | |
Completed |
NCT01954407 -
Young Adults' Responses to Anti-smoking Messages
|
N/A | |
Completed |
NCT03448900 -
Intervention Study for Smoking Cessation in Spanish College Students
|
N/A |