Smoking Cessation Clinical Trial
Official title:
Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2016: a Single-blind Cluster Randomized Controlled Trial on High Intensity Active Referral and Simple Text Messaging to Achieve Abstinence
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.
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.
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