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Article: Effectiveness of a brief self-determination theory-based smoking cessation intervention for smokers at emergency departments in Hong Kong: a randomized clinical trial

TitleEffectiveness of a brief self-determination theory-based smoking cessation intervention for smokers at emergency departments in Hong Kong: a randomized clinical trial
Authors
Issue Date2020
PublisherAmerican Medical Association. The Journal's web site is located at http://archinte.jamanetwork.com/journal.aspx
Citation
JAMA Internal Medicine, 2020, v. 180 n. 2, p. 206-214 How to Cite?
AbstractImportance: Clinicians have an opportunity to provide smoking cessation interventions to smokers who present to emergency departments (EDs). The effectiveness of a brief intervention based on self-determination theory for smoking cessation is uncertain. Objective: To examine the effectiveness of a brief intervention based on self-determination theory for smoking cessation (immediate or progressive) among Chinese smokers presenting at EDs in Hong Kong. Design, Setting, and Participants: This single-blind, multicenter intent-to-treat randomized clinical trial was conducted at the EDs of 4 major acute care hospitals in different districts of Hong Kong. In total, 1571 smokers 18 years or older who presented at 4 major EDs between July 4, 2015, and March 17, 2017, were randomized into an intervention group (n = 787) and a control group (n = 784). Interventions: The intervention group received brief advice (about 1 minute) and could choose their own quit schedules (immediate or progressive). The control group received a smoking cessation leaflet. Main Outcomes and Measures: Follow-up visits were conducted at 1, 3, 6, and 12 months. The primary outcome measure, by intent to treat, was biochemically validated abstinence at 6 months. Results: Participants (N = 1571) included 1381 men (87.9%); the mean (SD) age at baseline was 47.4 (16.4) years. Among participants who self-reported abstinence at 6 months, 50.3% (85 of 169) had biochemical validation by both an exhaled carbon monoxide test and a saliva cotinine test. Compared with the control group, the intervention group had statistically higher biochemically validated abstinence at 6 months: 6.7% (53 of 787) vs 2.8% (22 of 784) (P < .001), with an adjusted relative risk of 3.21 (95% CI, 1.74-5.93; P < .001). The intervention group also had higher self-reported quit rates at 6 months (12.2% [96 of 787] vs 9.3% [73 of 784], P = .04) and 12 months (13.0% [102 of 787] vs 8.5% [67 of 784], P < .01), as well as higher biochemically validated abstinence at 12 months (7.0% [55 of 787] vs 3.7% [29 of 784], P < .001). The additional cost for each intervention group participant was US $0.47, with an estimated gain of 0.0238 quality-adjusted life-year. The incremental cost per quality-adjusted life-year (US $19.53) fell within acceptable thresholds. Conclusions and Relevance: This brief, low-cost self-determination theory–based intervention for smokers presenting at EDs effectively increased the biochemically validated quit rate at 6 months. If delivered routinely, such a simple intervention may offer a cost-effective and sustainable approach to help many smokers quit smoking. Trial Registration: ClinicalTrials.gov identifier: NCT02660957
Persistent Identifierhttp://hdl.handle.net/10722/279386
ISSN
2021 Impact Factor: 44.409
2020 SCImago Journal Rankings: 5.140
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, WHC-
dc.contributor.authorHo, KY-
dc.contributor.authorWang, MP-
dc.contributor.authorCheung, DYT-
dc.contributor.authorLam, KKW-
dc.contributor.authorXia, W-
dc.contributor.authorCheung, KY-
dc.contributor.authorWong, CKH-
dc.contributor.authorChan, SSC-
dc.contributor.authorLam, TH-
dc.date.accessioned2019-11-01T07:16:19Z-
dc.date.available2019-11-01T07:16:19Z-
dc.date.issued2020-
dc.identifier.citationJAMA Internal Medicine, 2020, v. 180 n. 2, p. 206-214-
dc.identifier.issn2168-6106-
dc.identifier.urihttp://hdl.handle.net/10722/279386-
dc.description.abstractImportance: Clinicians have an opportunity to provide smoking cessation interventions to smokers who present to emergency departments (EDs). The effectiveness of a brief intervention based on self-determination theory for smoking cessation is uncertain. Objective: To examine the effectiveness of a brief intervention based on self-determination theory for smoking cessation (immediate or progressive) among Chinese smokers presenting at EDs in Hong Kong. Design, Setting, and Participants: This single-blind, multicenter intent-to-treat randomized clinical trial was conducted at the EDs of 4 major acute care hospitals in different districts of Hong Kong. In total, 1571 smokers 18 years or older who presented at 4 major EDs between July 4, 2015, and March 17, 2017, were randomized into an intervention group (n = 787) and a control group (n = 784). Interventions: The intervention group received brief advice (about 1 minute) and could choose their own quit schedules (immediate or progressive). The control group received a smoking cessation leaflet. Main Outcomes and Measures: Follow-up visits were conducted at 1, 3, 6, and 12 months. The primary outcome measure, by intent to treat, was biochemically validated abstinence at 6 months. Results: Participants (N = 1571) included 1381 men (87.9%); the mean (SD) age at baseline was 47.4 (16.4) years. Among participants who self-reported abstinence at 6 months, 50.3% (85 of 169) had biochemical validation by both an exhaled carbon monoxide test and a saliva cotinine test. Compared with the control group, the intervention group had statistically higher biochemically validated abstinence at 6 months: 6.7% (53 of 787) vs 2.8% (22 of 784) (P < .001), with an adjusted relative risk of 3.21 (95% CI, 1.74-5.93; P < .001). The intervention group also had higher self-reported quit rates at 6 months (12.2% [96 of 787] vs 9.3% [73 of 784], P = .04) and 12 months (13.0% [102 of 787] vs 8.5% [67 of 784], P < .01), as well as higher biochemically validated abstinence at 12 months (7.0% [55 of 787] vs 3.7% [29 of 784], P < .001). The additional cost for each intervention group participant was US $0.47, with an estimated gain of 0.0238 quality-adjusted life-year. The incremental cost per quality-adjusted life-year (US $19.53) fell within acceptable thresholds. Conclusions and Relevance: This brief, low-cost self-determination theory–based intervention for smokers presenting at EDs effectively increased the biochemically validated quit rate at 6 months. If delivered routinely, such a simple intervention may offer a cost-effective and sustainable approach to help many smokers quit smoking. Trial Registration: ClinicalTrials.gov identifier: NCT02660957-
dc.languageeng-
dc.publisherAmerican Medical Association. The Journal's web site is located at http://archinte.jamanetwork.com/journal.aspx-
dc.relation.ispartofJAMA Internal Medicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleEffectiveness of a brief self-determination theory-based smoking cessation intervention for smokers at emergency departments in Hong Kong: a randomized clinical trial-
dc.typeArticle-
dc.identifier.emailLi, WHC: william3@hkucc.hku.hk-
dc.identifier.emailHo, KY: devilbb2@hku.hk-
dc.identifier.emailWang, MP: mpwang@hku.hk-
dc.identifier.emailCheung, DYT: takderek@hku.hk-
dc.identifier.emailLam, KKW: kathin@connect.hku.hk-
dc.identifier.emailXia, W: xiavive@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailChan, SSC: scsophia@hku.hk-
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hk-
dc.identifier.authorityLi, WHC=rp00528-
dc.identifier.authorityHo, KY=rp02339-
dc.identifier.authorityWang, MP=rp01863-
dc.identifier.authorityCheung, DYT=rp02262-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityChan, SSC=rp00423-
dc.identifier.authorityLam, TH=rp00326-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1001/jamainternmed.2019.5176-
dc.identifier.pmid31790546-
dc.identifier.pmcidPMC6902195-
dc.identifier.scopuseid_2-s2.0-85075906704-
dc.identifier.hkuros308433-
dc.identifier.volume180-
dc.identifier.issue2-
dc.identifier.spage206-
dc.identifier.epage214-
dc.identifier.isiWOS:000512041500006-
dc.publisher.placeUnited States-
dc.identifier.issnl2168-6106-

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