Prevention Science

, Volume 19, Issue 2, pp 209–219 | Cite as

A Brief Smoking Cessation Advice by Youth Counselors for the Smokers in the Hong Kong Quit to Win Contest 2010: a Cluster Randomized Controlled Trial

  • Sophia Siu Chee Chan
  • Yee Tak Derek Cheung
  • Yee Man Bonny Wong
  • Antonio Kwong
  • Vienna Lai
  • Tai-hing Lam
Article
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Abstract

Smoking cessation counseling by healthcare professionals is effective, but very few healthcare professionals can deliver these interventions in the busy clinical settings. This study aimed to evaluate the effectiveness of a brief smoking cessation advice delivered by briefly-trained youth counselors at the enrolment of an incentive-based smoking cessation campaign. The study design was a cluster 2-arm randomized controlled trial of 831 Chinese adult smokers who were recruited in public areas to participate in the Hong Kong Quit to Win Contest 2010. The intervention group (n = 441) received a 5-min quitting advice from the youth counselors, who were mainly undergraduate nursing students, and a 12-page self-help smoking cessation booklet at the enrolment, while the control group (n = 390) only received the same booklet. Biochemically confirmed quitters at 6-month follow-up could join a lucky draw that offered HK$10,000 (US$1282) cash prize to three winners and HK$4000 gift vouchers to the other 10 winners. Primary outcome was self-reported smoking abstinence at 6-month follow-up. By intention-to-treat, the intervention group had a non-significantly higher self-reported (18.4 versus 13.8%, OR = 1.40, 95% CI 0.96–2.04, p = 0.08) and validated quit rate (9.1 versus 6.7%, OR = 1.40, 95% CI 0.84–2.33, p = 0.20) than the control group at 6-month follow-up. The analysis with multiple imputation for missing data also found similar results. We concluded that the brief on-site advice by trained youth counselors had a modest effect on smoking cessation, but the effect was not significant. Future studies with larger sample size and results from higher participation of the biochemical validation to confirm the effectiveness are warranted.

Keywords

Smoking cessation Clinical trial Community health Quit and win Brief advice 
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Notes

Compliance with Ethical Standards

Funding

This study was funded by the Hong Kong Council on Smoking and Health (COSH).

Conflict of Interest

The chairman (Mr. Antonio Kwong) and the executive director (Ms. Vienna Lai) of the COSH are the co-authors of the present study. All authors do not have any connection with any researchers of the tobacco, alcohol, pharmaceutical or gaming industries or anybody substantially funded by one of these organizations, except Prof. Tai-hing Lam is the principal investigator, and Prof. Sophia Siu Chee Chan was the former investigator of the FAMILY project, which was funded by the Hong Kong Jockey Club Charities Trust.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (IRB: UW 10–239)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Appendix 1 (DOCX 18 kb)
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Appendix 2 (DOCX 19 kb)
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Appendix 3 (DOCX 19 kb)
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Appendix 4 (DOCX 20 kb)
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Appendix 5 (DOCX 18 kb)

References

  1. Abdullah, A. S., Lam, T. H., Chan, S. S. C., & Hedley, A. J. (2004). Which smokers use the smoking cessation Quitline in Hong Kong and how effective is the Quitline? Tobacco Control, 13, 415–421.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Allison, P. D. (2012) Handling missing data by maximum likelihood. SAS global forum. Google Scholar
  3. Aveyard, P. & Foulds, J. (2009) The 2009 US Clinical Practice Guideline: The key recommendations and a commentary. www.treatobacco.net 2009 Ask the Experts.
  4. Bains, N., Pickett, W., & Hoey, J. (1998). The use and impact of incentives in population-based smoking cessation programs: A review. American Journal of Health Promotion, 12, 307–320.CrossRefPubMedGoogle Scholar
  5. Borland, R., Li, L., Driezen, P., et al. (2012). Cessation assistance reported by smokers in 15 countries participating in the International Tobacco Control (ITC) policy evaluation surveys. Addiction, 107, 197–205.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Census & Statistics Department (Hong Kong SAR government). (2011). Thematic Household Survey, Report No. 48: Pattern of smoking. Hong Kong: Census & Statistics Department.Google Scholar
  7. Census & Statistics Department (Hong Kong SAR government). (2016). Thematic Household Survey, Report No. 59: Pattern of smoking. Hong Kong: Census & Statistics Department.Google Scholar
  8. Chan, S. S. C., Wong, D. C. N., Cheung, Y. T. D., et al. (2015). A block randomized controlled trial of a brief smoking cessation counselling and advice through short message service on participants who joined the Quit to Win Contest in Hong Kong. Health Education Research, 30, 609–621.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Chan, S. S. C., Cheung, Y. T. D., Wan, Z., Wang, M. P., & Lam, T.-H. (2016). Proactive and Brief Smoking Cessation Intervention for Smokers at Outdoor Smoking “Hotspots” in Hong Kong. Journal of Cancer Education, 1–6.Google Scholar
  10. Cheung, Y. T. D., Wang, M. P., Li, H. C. W., et al. (2017). Effectiveness of a small cash incentive on abstinence and use of cessation aids for adult smokers: A randomized controlled trial. Addictive Behaviors, 66, 17–25.CrossRefPubMedGoogle Scholar
  11. Collins, L. M., Schafer, J. L., & Kam, C.-M. (2001). A comparison of inclusive and restrictive strategies in modern missing data procedures. Psychological Methods, 6, 330–351.CrossRefPubMedGoogle Scholar
  12. Cropsey, K. L., Trent, L. R., Clark, C. B., Stevens, E. N., Lahti, A. C., & Hendricks, P. S. (2014). How low should you go? Determining the optimal cutoff for exhaled carbon monoxide to confirm smoking abstinence when using cotinine as reference. Nicotine & Tobacco Research, 16, 1348–1355.CrossRefGoogle Scholar
  13. Dong, Y., & Peng, C.-Y. J. (2013). Principled missing data methods for researchers. SpringerPlus, 2, 222.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Eldridge, S. M., Ashby, D., & Kerry, S. (2006). Sample size for cluster randomized trials: Effect of coefficient of variation of cluster size and analysis method. International Journal of Epidemiology, 35, 1292–1300.CrossRefPubMedGoogle Scholar
  15. Fiore, M. C., Jaén, C. R., Baker, T. B., et al. (2008). Treating tobacco use and dependence: 2008 update. MD: Department of Health and Human Services, Rockvill.Google Scholar
  16. Glasgow, R. E., Hollis, J. F., Ary, D. V., & Boles, S. M. (1993). Results of a year-long incentives-based worksite smoking-cessation program. Addictive Behaviors, 18, 455–464.CrossRefPubMedGoogle Scholar
  17. Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007). How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prevention Science, 8, 206–213.CrossRefPubMedGoogle Scholar
  18. Halpern, S. D., French, B., Small, D. S., et al. (2015). Randomized trial of four financial-incentive programs for smoking cessation. New England Journal of Medicine, 372, 2108–2117.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Hennrikus, D. J., Jeffery, R. W., Lando, H. A., et al. (2002). The SUCCESS project: The effect of program format and incentives on participation and cessation in worksite smoking cessation programs. American Journal of Public Health, 92, 274–279.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Javors, M. A., Hatch, J. P., & Lamb, R. J. (2011). Sequential combination of self-report, breath carbon monoxide, and saliva cotinine to assess smoking status. Drug and Alcohol Dependence, 113, 242–244.CrossRefPubMedGoogle Scholar
  21. Koffman, D. M., Lee, J. W., Hopp, J. W., & Emont, S. L. (1998). The impact of including incentives and competition in a workplace smoking cessation program on quit rates. American Journal of Health Promotion, 13, 105–111.CrossRefPubMedGoogle Scholar
  22. Koplan, J. P., An, W. K., & Lam, R. M. K. (2010). Hong Kong: A model of successful tobacco control in China. The Lancet, 375, 1330–1331.CrossRefGoogle Scholar
  23. Lam, T. H. (2012). Absolute risk of tobacco deaths: One in two smokers will be killed by smoking: Comment on “smoking and all-cause mortality in older people”. Archives of Internal Medicine, 172, 845–846.CrossRefPubMedGoogle Scholar
  24. Lam, T. H., Abdullah, A. S., Chan, S. S. C., & Hedley, A. J. (2005). Adherence versus quitting smoking: Predictors among Chinese smokers. Psychopharmacology, 177, 400–408.CrossRefPubMedGoogle Scholar
  25. Lam, T. H., Jiang, C., Chan, Y. F., & Chan, S. S. (2011). Smoking cessation intervention practices in Chinese physicians: Do gender and smoking status matter? Health & Social Care in the Community, 19, 126–137.Google Scholar
  26. Leung, D. Y. P., Chan, S. S. C., Jiang, C. Q., & Lam, T. H. (2009). Providing smoking cessation services and its relationship with knowledge and attitudes: A comparison of the Guangzhou and Hong Kong nurses. Journal of Comparative Asian Development, 8, 179–205.CrossRefGoogle Scholar
  27. Lin, P. R., Zhao, Z. W., Cheng, K.-K., & Lam, T.-H. (2013). The effect of physician’s 30 s smoking cessation intervention for male medical outpatients: A pilot randomized controlled trial. Journal of Public Health, 35, 375–383.CrossRefPubMedGoogle Scholar
  28. Lough, L. E., Ebbert, J. O., & McLeod, T. G. (2011). Evaluation of a student-run smoking cessation clinic for a medically underserved population. BMC Research Notes, 4, 1–8.CrossRefGoogle Scholar
  29. Mantzari, E., Vogt, F., Shemilt, I., Wei, Y., Higgins, J. P. T., & Marteau, T. M. (2015). Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis. Preventive Medicine, 75, 75–85.CrossRefPubMedPubMedCentralGoogle Scholar
  30. McGhee, S., Ho, L., Lapsley, H., et al. (2006). Cost of tobacco-related diseases, including passive smoking, in Hong Kong. Tobacco Control, 15, 125–130.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Montalto, N. J., & Wells, W. O. (2007). Validation of self-reported smoking status using saliva cotinine: A rapid semiquantitative dipstick method. Cancer Epidemiology Biomarkers & Prevention, 16, 1858–1862.CrossRefGoogle Scholar
  32. Murray, R. L., Lewis, S. A., Coleman, T., Britton, J., & McNeill, A. (2009). Unplanned attempts to quit smoking: Missed opportunities for health promotion? Addiction, 104, 1901–1909.CrossRefPubMedGoogle Scholar
  33. Newgard, C. D., & Lewis, R. J. (2015). Missing data: How to best account for what is not known. JAMA, 314, 940–941.CrossRefPubMedGoogle Scholar
  34. Rice, V. H., Hartmann-Boyce, J. & Stead, L. F. (2013) Nursing interventions for smoking cessation. Cochrane Database of Systematic Reviews, 2013, CD001188.Google Scholar
  35. Richard, J. C., & David, L. S. (1995). The number needed to treat: A clinically useful measure of treatment effect. BMJ, 310, 452.CrossRefGoogle Scholar
  36. Rubin, D. B. (2004). Multiple imputation for nonresponse in surveys. New York: John Wiley & Sons.Google Scholar
  37. Sally, M. K., & Bland, J. M. (1998). The intracluster correlation coefficient in cluster randomisation. BMJ, 316, 1455.Google Scholar
  38. Schafer, J. L. (1997). Analysis of incomplete multivariate data. New York: Chapman and Hall.CrossRefGoogle Scholar
  39. Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147–177.CrossRefPubMedGoogle Scholar
  40. Shibly, O. (2010). Effect of tobacco counseling by dental students on patient quitting rate. Journal of Dental Education, 74, 140–148.PubMedGoogle Scholar
  41. Starr, G., Rogers, T., Schooley, M., Porter, S., Wiesen, E., & Jamison, N. (2005). Key outcome indicators for evaluating comprehensive tobacco control programs. Atlanta: Centers for Disease Control and Prevention.Google Scholar
  42. Stead, L. F., Buitrago, D., Preciado, N., Sanchez, G., Hartmann-Boyce, J., & Lancaster, T. (2013). Physician advice for smoking cessation. Cochrane Database of Systematic Reviews, 2013.Google Scholar
  43. Tsoh, J. Y., Burke, N. J., Gildengorin, G., et al. (2015). A social network family-focused intervention to promote smoking cessation in Chinese and Vietnamese American male smokers: A feasibility study. Nicotine & Tobacco Research, 17, 1029–1038.CrossRefGoogle Scholar
  44. Volpp, K. G., Gurmankin Levy, A., Asch, D. A., et al. (2006). A randomized controlled trial of financial incentives for smoking cessation. Cancer Epidemiology Biomarkers & Prevention, 15, 12–18.CrossRefGoogle Scholar
  45. Volpp, K. G., Troxel, A. B., Pauly, M. V., et al. (2009). A randomized, controlled trial of financial incentives for smoking cessation. New England Journal of Medicine, 360, 699–709.CrossRefPubMedGoogle Scholar
  46. Yuan, Y. C. (2010). Multiple imputation for missing data: Concepts and new development (version 9.0) (p. 49). Rockville: SAS Institute Inc.Google Scholar
  47. Yuan, N. P., Castañeda, H., Nichter, M., et al. (2012). Lay health influencers: How they tailor brief tobacco cessation interventions. Health Education & Behavior, 39, 544–554.CrossRefGoogle Scholar

Copyright information

© Society for Prevention Research 2017

Authors and Affiliations

  1. 1.School of Nursing, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
  2. 2.Department of Health and Physical EducationThe Education University of Hong KongHong KongChina
  3. 3.Hong Kong Council on Smoking and HealthHong KongChina
  4. 4.School of Public HealthThe University of Hong KongHong KongChina

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