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

Not Applicable

• Conditions: Smoking Cessation

• 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.

Study Timeline

• Study First Submitted: 2021-05-26
• Study First Submitted QC: 2021-05-26
• Study First Posted: 2021-06-01
• Study Start: 2021-06-12
• Primary Completion: 2022-06-30
• Status Verified: 2022-08
• Last Update Submitted: 2022-08-14
• Last Update Posted: 2022-08-17
• Study Completion: 2023-06-30

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

Exclusion Criteria

• Smokers who have communication barrier (either physically or cognitively)
• Smokers who are currently participating in other SC programmes or services

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Biochemically validated abstinence	6-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

Name	Time	Method
Self-reported depressive symptoms	6-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 affect	6-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 health	6-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 attempts	6-month follow-up	Number of quit attempts from baseline at 6-month follow-up
Self-reported social support	6-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 loneliness	6-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 reduction	6-month follow-up	Defined by at least 50% reduction in baseline daily number of cigarettes
Self-reported anxious symptoms	3-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 resilience	6-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.
Biochemically validated abstinence	3-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 7-day point prevalence quit rate	6-month follow-up	Smokers who did not smoke even a puff in the 7 days preceding the follow-up
Self-reported use of smoking cessation service	6-month follow-up	Use of smoking cessation service at 3- and 6- month follow-up
Self-reported happiness	6-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 optimistic	6-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 stress	3-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 affect	3-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