Predictors of smoking cessation service use and its effect on quitting among smokers in 2015 "Quit To Win" Contest in Hong Kong

Abstract

SIGNIFICANCE: We investigated active referral of smokers to smoking cessation (SC) services, predictors of successful SC service use and the effects on quitting in participants of 2015 COSH “Quit to Win” Contest in Hong Kong. METHODS: In a cluster randomised controlled trial on brief advice and active referral on quitting (N=1226), 402 smokers (78.9% male, mean age 40.8±14.9 years) were randomly assigned to receive on site brief advice using AWARD (Ask, Warn about 1 out of 2 smokers will be killed by smoking, Advice, Refer and Do-it-again) model, a health warning leaflet, an SC services information card and an active referral for a quick SC appointment by transferring their contacts to their chosen service providers. Referral would be arranged again for smokers who could not receive call from service providers in the follow-ups. Logistic regression was used to analyse the factors and quitting associated with SC service use. RESULTS: 85.3% participants had chosen an SC service provider and 0.2% (n=1) refused referral. Among those who had chosen a service provider (n=343), 72.9% (n=250; 80.0% male, mean age 42.4 ±14.2 years) were successfully contacted by the service providers. Among them, 39.6% used the SC services. In the users (n=99), 22.2% received SC counselling only while 43.4% had varenicline, 41.4% had nicotine replacement therapy and 26.2% had acupuncture (some had more than one of the three). Busy schedule (61.6%) and time mismatch (49.7%) were the most common reasons for not using SC services. Participants aged 26-35 (odds ratio(OR)=0.02(95%CI 0.08- 0.48)), perceiving smoking as important (per unit OR increase=1.21(1.01-1.44)) and receiving the first call from service providers within 1 month after baseline were strongly associated with service use (OR=13.12(2.91-59.1)). At 6-month, the overall self-reported and biochemically validated quit rate was 21.6% and 11.2 % respectively. Use of SC services was associated with quitting (OR=2.30(1.25- 4.24)) and biochemically validated quitting (OR=5.54(2.26-13.61)). CONCLUSION: Early proactive contact and referring smokers to SC service providers was associated with more SC service use, which significantly increased quit rate.