Semi-personalized smoking cessation interventions for adult smokers recruited at smoking hotspots: a pilot randomized controlled trial

Dr Wang, Man Ping   (Principal Investigator (PI))

Mr Wu Yongda   (Co-Investigator)

Dr Li William Ho Cheung   (Co-Investigator)

Emeritus Professor Lam Tai Hing   (Co-Investigator)

Dr Ho Daniel Sai Yin   (Co-Investigator)

5

2017-07-01

40000

Semi-personalized smoking cessation interventions for adult smokers recruited at smoking hotspots: a pilot randomized controlled trial

AWARD, Instant messaging, Randomized control trial, Semi-personalized smoking cessation

Population Health,Epidemiology

N/A

Seed Fund for Basic Research for Resubmission of GRF/ECS Proposals

2017

Completed

This proposed pilot randomized controlled trial (RCT) aims to assess the effect of a supportive semi-personalized smoking cessation (SC) advice delivered by instant messaging (IM)(e.g. WhatsApp/WeChat) on quitting in adult smokers recruited at smoking hotspots (SH, a public outdoor place where smokers stop/linger and smoke).Semi-personalised advice and intervention according to smokers’ quitting progress will be used to increase smokers’ motivation to quit, use their preferred SC services and quitting. As most smokers recruited in the SH have low intention to quit and are not ready to use SC services, semi-personalized SC advices through IM could be more effective for engaging them in SC conversations and subsequently guiding them on choosing preferred SC services and intervention. We will randomly select 6 SH from different locations in Hong Kong Island, Kowloon and New Territories (2 in each regions). Two SC ambassadors (student helpers with half-day training) and one supervisor (experienced research assistant) will be deployed for each recruitment session. SC ambassadors will approach smokers using a ""foot-in-the-door"" technique. Potential smokers will be validated using breath carbon monoxide (CO) (>4ppm) and complete a short questionnaire. Participant (N=100) will be individually randomized (with allocation concealment) to intervention group and control group (1:1) and followed at 1 and 3 months using telephones. At baseline, both groups will receive validated AWARDSC advice, a SC services referral card and a health warning leaflet. Smokers will also receive 1-week free nicotine replacement therapy (NRT) if they prefer. General SC messages (e.g. harm of smoking, benefit of SC) through SMS (control group) and IM (intervention group) will be sent twice per week for 2 months. SC ambassadors will interact using WhatsApp/WeChat with smokers in the intervention groups using proactive and empathetic skills. Semi-personalized (according to smokers’ year of smoking, addiction level, readiness to quit, gender and age) supportive IM messages will be used to engage smokers in the conversation. Depending on the preference and quitting progress of smokers, they will receive semi-personalized intervention: (1) SC services (e.g. acupuncture, face-to-face counselling) or NRT for smokers reporting difficulties in quitting; SC ambassadors will help with referral or delivery of 1-week free NRT sample;(2) more frequent IM messages for smokers having difficulties but not willing to use other SC services; (3) ongoing regular IM messages for smokers progressing well in quitting or without any action, to prevent relapse; (4) telephone counselling by an experienced smoking cessation counsellor (we expect very few would prefer this). The above 4 can be inter-changed according to the preference of the smoker. The IM or counselling intervention will last for 2 months. Smokers in the control group will only receive regular general SC SMS messages for 2 months. Primary outcome is exhaled CO validated abstinence at 3-month. Major secondary outcomes include self-reported past 7-day point prevalence abstinence, nicotine addiction level, quit intention and attempts, smoking reduction, SC service and NRT use at 3-month follow-up. Outcome assessors will be blinded to group allocation. We will follow the CONSORT strictly. The findings will provide much needed and original evidence on developing new, proactive, useful, simple and cost effective SC advices semi-personalized to smokers’ quitting progress for improving SC and policy for adult smokers who do not actively seek help from SC services in Hong Kong.