Comparing Different Intensities of Active Referral to Smoking Cessation Services in Promoting Smoking Cessation Among Community Smokers: a Study Protocol of a Cluster Randomized Controlled Trial

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2018 Jul 6

PMID 29973191

Citations 3

Authors

Xue Weng

Man Ping Wang

Yi Nam Suen

William Ho Cheung Li

Yongda Wu

Derek Yee Tak Cheung

Antonio Cho Shing Kwong

Vienna Wai Yin Lai

Sophia Siu Chee Chan

Tai Hing Lam

Affiliations

Soon will be listed here.

Abstract

Background: Actively referring smokers to smoking cessation (SC) services could increase quitting and is scalable for the population. The objective of this study is to compare 2 different intensities of SC active referral for smokers in the community of Hong Kong.

Methods/design: This is a single-blind, parallel 3-armed cluster randomized controlled trial (cRCT) consisting of high-intensity SC active referral (HAR Group), low-intensity SC referral by text messaging on promoting SC services use (Text Group) and a control group receives general very brief advice. Biochemically validated daily smokers will be proactively recruited in the community from 68 clusters (recruitment sessions). The primary outcome is self-reported 7-days point prevalence abstinence (PPA) at the 3- and 6- month follow-ups. Secondary outcomes are SC service use, smoking reduction rate (SRR, daily cigarette consumption reduced by ≥50%; excluding quitters) and biochemically validated quit rate (exhaled CO < 4 ppm and salivary cotinine < 10 ng/ml). Outcome assessors and data analysts will be blinded to group allocation. Intention-to-treat principle and Generalized Estimating Equation (GEE) regressions will be used for data analysis.

Discussion: This will be the first trial on evaluating the efficacy of the 2 different intensities of SC active referral on smoking cessation in community smokers. It is anticipated that the results from this trial can provide evidence to the effectiveness of high-intensity active referral to SC services and low intensity SC referral by using text messaging in achieving smoking abstinence.

Trial Registration: ClinicalTrials.gov Identifier: NCT02804880 , June 17, 2016.

Citing Articles

Evaluating the Effectiveness of Brief Interventions for Smoking Cessation Performed by Family Doctors.

Chirila S, Grasa C, Gurgas L, Cristurean C, Hanzu-Pazara L, Hangan T Medicina (Kaunas). 2025; 60(12.

PMID: 39768864 PMC: 11728199. DOI: 10.3390/medicina60121985.

Mobile phone text messaging and app-based interventions for smoking cessation.

Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y, Dobson R Cochrane Database Syst Rev. 2019; 10:CD006611.

PMID: 31638271 PMC: 6804292. DOI: 10.1002/14651858.CD006611.pub5.

Prevalence of tobacco related chronic diseases and its role in smoking cessation among smokers in a rural area of Shanghai, China: a cross sectional study.

Wang R, Jiang Y, Yao C, Zhu M, Zhao Q, Huang L BMC Public Health. 2019; 19(1):753.

PMID: 31196049 PMC: 6567455. DOI: 10.1186/s12889-019-7110-9.

Exploring Community Smokers' Perspectives for Developing a Chat-Based Smoking Cessation Intervention Delivered Through Mobile Instant Messaging: Qualitative Study.

Luk T, Wong S, Lee J, Chan S, Lam T, Wang M JMIR Mhealth Uhealth. 2019; 7(1):e11954.

PMID: 30702431 PMC: 6374728. DOI: 10.2196/11954.

References

Hyland A, Borland R, Li Q, Yong H, McNeill A, Fong G . Individual-level predictors of cessation behaviours among participants in the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006; 15 Suppl 3:iii83-94. PMC: 2593055. DOI: 10.1136/tc.2005.013516. View

Chan S, Wong D, Cheung Y, Leung D, Lau L, Lai V . 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 Educ Res. 2015; 30(4):609-21. PMC: 4817085. DOI: 10.1093/her/cyv023. View

McDonald P . Population-based recruitment for quit-smoking programs: an analytic review of communication variables. Prev Med. 1999; 28(6):545-57. DOI: 10.1006/pmed.1998.0479. View

Guy M, Seltzer R, Cameron M, Pugmire J, Michael S, Leischow S . Relationship between smokers' modes of entry into quitlines and treatment outcomes. Am J Health Behav. 2012; 36(1):3-11. PMC: 3864802. DOI: 10.5993/ajhb.36.1.1. View

Vidrine J, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B . Ask-Advise-Connect: a new approach to smoking treatment delivery in health care settings. JAMA Intern Med. 2013; 173(6):458-64. PMC: 3858085. DOI: 10.1001/jamainternmed.2013.3751. View

Cooke F, Bullen C, Whittaker R, McRobbie H, Chen M, Walker N . Diagnostic accuracy of NicAlert cotinine test strips in saliva for verifying smoking status. Nicotine Tob Res. 2008; 10(4):607-12. DOI: 10.1080/14622200801978680. View

Tindle H, Daigh R, Reddy V, Bailey L, Ochs J, Maness M . eReferral Between Hospitals and Quitlines: An Emerging Tobacco Control Strategy. Am J Prev Med. 2016; 51(4):522-6. DOI: 10.1016/j.amepre.2016.05.024. View

FREEDMAN J, Fraser S . Compliance without pressure: the foot-in-the-door technique. J Pers Soc Psychol. 1966; 4(2):195-202. DOI: 10.1037/h0023552. View

Free C, Knight R, Robertson S, Whittaker R, Edwards P, Zhou W . Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial. Lancet. 2011; 378(9785):49-55. PMC: 3143315. DOI: 10.1016/S0140-6736(11)60701-0. View

10.

Cheung Y, Wang M, Li H, Kwong A, Lai V, Chan S . Effectiveness of a small cash incentive on abstinence and use of cessation aids for adult smokers: A randomized controlled trial. Addict Behav. 2016; 66:17-25. DOI: 10.1016/j.addbeh.2016.11.006. View

11.

Wang M, Li W, Cheung Y, Lam O, Wu Y, Kwong A . Brief Advice on Smoking Reduction Versus Abrupt Quitting for Smoking Cessation in Chinese Smokers: A Cluster Randomized Controlled Trial. Nicotine Tob Res. 2017; 20(1):67-72. DOI: 10.1093/ntr/ntx026. View

12.

Suen Y, Wang M, Li W, Kwong A, Lai V, Chan S . Brief advice and active referral for smoking cessation services among community smokers: a study protocol for randomized controlled trial. BMC Public Health. 2016; 16:387. PMC: 4866301. DOI: 10.1186/s12889-016-3084-z. View

13.

Borland R, Balmford J, Benda P . Population-level effects of automated smoking cessation help programs: a randomized controlled trial. Addiction. 2012; 108(3):618-28. DOI: 10.1111/j.1360-0443.2012.04091.x. View

14.

Abroms L, Boal A, Simmens S, Mendel J, Windsor R . A randomized trial of Text2Quit: a text messaging program for smoking cessation. Am J Prev Med. 2014; 47(3):242-50. PMC: 4545234. DOI: 10.1016/j.amepre.2014.04.010. View

15.

Thomsen T, Villebro N, Moller A . Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014; (3):CD002294. PMC: 7138216. DOI: 10.1002/14651858.CD002294.pub4. View

16.

Borland R, Segan C . The potential of quitlines to increase smoking cessation. Drug Alcohol Rev. 2006; 25(1):73-8. DOI: 10.1080/09595230500459537. View

17.

Wang M, Suen Y, Li W, Lam C, Wu S, Kwong A . Intervention With Brief Cessation Advice Plus Active Referral for Proactively Recruited Community Smokers: A Pragmatic Cluster Randomized Clinical Trial. JAMA Intern Med. 2017; 177(12):1790-1797. PMC: 5820734. DOI: 10.1001/jamainternmed.2017.5793. View

18.

Javors M, Hatch J, Lamb R . Cut-off levels for breath carbon monoxide as a marker for cigarette smoking. Addiction. 2005; 100(2):159-67. DOI: 10.1111/j.1360-0443.2004.00957.x. View

19.

Borland R, Balmford J, Bishop N, Segan C, Piterman L, McKay-Brown L . In-practice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomized trial. Fam Pract. 2008; 25(5):382-9. DOI: 10.1093/fampra/cmn046. View

20.

Schulz K, Altman D, Moher D . CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2011; 9(8):672-7. DOI: 10.1016/j.ijsu.2011.09.004. View