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Mobile-based Positive Psychological Support for Smoking Cessation Via "Quit to Win" Contest 2021 (QTW 2021)

Not Applicable
Conditions
Smoking Cessation
Interventions
Behavioral: AWARD advice
Other: Brief leaflet on health warning and smoking cessation
Other: Referral card
Other: Self-help smoking cessation booklet
Behavioral: Positive psychological support through 3-people group chat using instant messaging apps
Behavioral: E-messages via SMS
Registration Number
NCT04909320
Lead Sponsor
The University of Hong Kong
Brief Summary

This study aims to explore the effectiveness of a combined intervention using brief cessation advice and personalized chat-based positive psychological support compared with the control group on current smokers who join the Quit to Win Contest.

Detailed Description

Smoking is a leading cause of many diseases and deaths globally. Although Hong Kong has a relatively low overall smoking rate of 10.2% (in 2019), health and economic burdens due to smoking are still substantial. The practice of smoking might predispose smokers to COVID-19 infection and poor prognosis. Growing evidence has also suggested that smokers are at higher risk of developing serious respiratory and cardiovascular symptoms in the COVID-19 pandemic than non-smokers. Smoking cessation in the post-COVID-19 era is the key priority to meet the HKSAR Government's target of reducing smoking prevalence to 7.8% by 2025.

Mental health problems are commonly comorbid with smoking and related problems. Our population-based survey amidst the COVID-19 pandemic found current smokers were at higher risk of suffering from anxious symptoms (adjusted OR 1.84 95% CI 1.27, 2.67), depressive symptoms (adjusted OR 2.04 95% CI 1.40, 2.96), and stress symptoms (adjusted β 0.54 95% CI 0.26, 0.82) compared with non-smokers. We also observed mental health burden increased during the COVID-19 pandemic with approximately doubling of the prevalence of anxious symptoms (15.8 vs. 9.3) and depressive symptoms (14.8 vs. 6.3) compared with the pre-COVID-19 pandemic (2017). Mental health can be both precursors and consequences of smoking. Previous studies have suggested that depressive symptoms and low positive affect during and after SC attempts are associated with poor cessation outcomes. This implies that a combined intervention of behavioral and psychological SC intervention is needed, particularly under the circumstance of worsening mental health problems.

Therefore, our study aims to test the effectiveness of a combined intervention using brief cessation advice and personalized chat-based positive psychological support compared with the control group on current smokers who join the Quit to Win Contest.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
1094
Inclusion Criteria
  • Hong Kong residents aged 18 or above
  • Smoke at least 1 tobacco stick (includes HTP) per day or use e-cigarette daily in the past 3-month
  • Able to communicate in Chinese
  • Saliva cotinine 30 ng/ml or above
  • Intent to quit/reduce smoking
  • Able to use the instant messaging tool (e.g., WhatsApp, WeChat) for communication
Read More
Exclusion Criteria
  • Smokers who have communication barrier (either physically or cognitively)
  • Smokers who are currently participating in other SC programmes or services
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupAWARD advice-
Intervention groupReferral card-
Intervention groupPositive psychological support through 3-people group chat using instant messaging apps-
Control groupAWARD advice-
Control groupReferral card-
Control groupBrief leaflet on health warning and smoking cessation-
Intervention groupBrief leaflet on health warning and smoking cessation-
Intervention groupSelf-help smoking cessation booklet-
Control groupSelf-help smoking cessation booklet-
Control groupE-messages via SMS-
Primary Outcome Measures
NameTimeMethod
Biochemically validated abstinence6-month follow-up

Defined as exhaled CO level \<4ppm and saliva cotinine level ≤30 ng/ml

Note

1. If participants refuse to have a face-to-face exhaled carbon monoxide test due to the COVID-19 pandemic in Hong Kong. In that case, the outcome will only be validated by a saliva cotinine test device.

2. If participants use NRT, the outcome will be validated by exhaled carbon monoxide only.

Secondary Outcome Measures
NameTimeMethod
Self-reported depressive symptoms6-month follow-up

Measured by Patient Health Questionnaire-2 (PHQ-2). PHQ-2 ranges from 0-6, a higher score indicates a severer depressive symptom.

Self-reported positive affect6-month follow-up

The subscale of the Chinese version International Positive and Negative Affect Schedule Short Form (I-PANAS-SF) will measure self-reported positive affect. The I-PANAS-SF uses a 5-point scale, a higher score indicates a higher level of self-reported positive affect.

Self-rated health6-month follow-up

Self-rated health will be measured as a single item with the response items "excellent", "very good", "good", "fair", or "poor".

Self-reported quit attempts6-month follow-up

Number of quit attempts from baseline at 6-month follow-up

Self-reported social support6-month follow-up

A single item will measure self-reported social support with an answer on an 11-point scale (0-10). A higher score indicates a higher level of social support.

Self-reported loneliness6-month follow-up

A single item will measure self-reported loneliness with an answer on an 11-point scale (0-10). A higher score indicates a higher level of loneliness.

Self-reported 7-day point prevalence quit rate6-month follow-up

Smokers who did not smoke even a puff in the 7 days preceding the follow-up

Self-reported reduction6-month follow-up

Defined by at least 50% reduction in baseline daily number of cigarettes

Self-reported anxious symptoms3-month follow-up

Measured by Generalized Anxiety Disorder-2 (GAD-2). GAD-2 ranges from 0-6, a higher score indicates a severer anxious symptom.

Self-reported resilience6-month follow-up

A single item will measure self-reported resilience with an answer on an 11-point scale (0-10). A higher score indicates a higher level of resilience.

Self-reported use of smoking cessation service6-month follow-up

Use of smoking cessation service at 3- and 6- month follow-up

Biochemically validated abstinence3-month follow-up

Defined as exhaled CO level \<4ppm and saliva cotinine level ≤30 ng/ml

Note

1. If participants refuse to have a face-to-face exhaled carbon monoxide test due to the COVID-19 pandemic in Hong Kong. In that case, the outcome will only be validated by a saliva cotinine test device.

2. If participants use NRT, the outcome will be validated by exhaled carbon monoxide only.

Self-reported happiness6-month follow-up

A single item will measure self-reported happiness with an answer on an 11-point scale (0-10). A higher score indicates a higher level of happiness.

Self-reported optimistic6-month follow-up

A single item will measure self-reported optimistic with an answer on an 11-point scale (0-10). A higher score indicates a higher level of optimistic.

Self-reported stress3-month follow-up

A single item will measure self-reported stress with an answer on an 11-point scale (0-10). A higher score indicates a higher level of stress.

Self-reported negative affect3-month follow-up

The subscale of the Chinese version International Positive and Negative Affect Schedule Short Form (I-PANAS-SF) will measure self-reported negative affect. The I-PANAS-SF uses a 5-point scale, a higher score indicates a higher level of self-reported negative affect.

Trial Locations

Locations (1)

Hong Kong Council on Smoking and Health (COSH)

🇨🇳

Hong Kong, Hong Kong, China

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