Personalized Support Using Instant Messaging Applications to Increase Smoking Cessation

Not Applicable

• Conditions: Smoking Cessation
• Interventions: Behavioral: AWARD advice; Behavioral: Health warning leaflet; Behavioral: Active referral to smoking cessation (SC) services; Behavioral: Regular messages through Instant Messaging (IM); Behavioral: Message on general health delivered by short message service (SMS); Behavioral: Psychosocial support and referral to SC services through IM

• Registration Number: NCT03800719
• Lead Sponsor: The University of Hong Kong

Brief Summary

This study aims to assess the effect of personalized support using instant messaging application on smoking cessation in smokers proactively recruited from smoking hotspots in Hong Kong.

Detailed Description

Detailed Description: With the advancement of information communication technologies (ICTs), instant messaging applications (IM Apps, e.g. WhatsApp and WeChat) can be used for providing synchronous, personalized, interactive interventions for health promotion. This study proposes to apply IM Apps for enhancing our tested brief smoking cessation (SC) intervention model from AWARD to e-AWARD (AWARD: Ask, Warn, Advise, Refer, Do-it-again,) without medications to increase SC in smokers proactively recruited in smoking hotspots in Hong Kong. Such smokers are the majority and have low quit rate. IM Apps allows trained SC advisors to proactively deliver personalized SC advices, response to smokers' needs promptly, and provide psychosocial support. No similar trials are found in PubMed, Cochrane Library and trial registries (ClinicalTrials.gov \& ISRCTN) (except the pilot trial of this study). The aims of this study are as follows:

1. To assess the main effect of the personalized support using instant messaging applications (Intervention) vs. Control group on biochemical validated smoking abstinence at 6-month and 12-month.

2. To assess the effects on self-reported past 7-day abstinence, 24-week continuous abstinence, smoking reduction, self-efficacy of quitting, intention to quit, quit attempts and SC medications and services use at 6-month and 12-month.

3. To identify the mediators, which can inform mechanisms of the intervention on SC.

4. To evaluate the cost-effectiveness of the above interventions.

5. To understand the effects subjects' experience of IM support on SC using a qualitative study approach.

Study Timeline

• Study Start: 2018-12-15
• Study First Submitted: 2019-01-08
• Study First Submitted QC: 2019-01-09
• Study First Posted: 2019-01-11
• Status Verified: 2019-09
• Last Update Submitted: 2019-09-26
• Last Update Posted: 2019-09-30
• Primary Completion: 2020-12-31
• Study Completion: 2020-12-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 696

Inclusion Criteria

• Adult smokers aged 18+ who smoke cigarette(s) daily.
• Exhaled carbon monoxide (CO) level of 4ppm or above.
• Having smartphones with IM Apps (WhatsApp) and have experience in using.
• Hong Kong residents able to read and communicate in Chinese (Cantonese or Putonghua).

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Exclusion Criteria

• Smokers who have psychiatric/psychological diseases or are on regular psychotropic medications.
• Smokers who are using SC medication, NRT, other SC services or projects.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention Group	AWARD advice	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM
Intervention Group	Health warning leaflet	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM
Intervention Group	Psychosocial support and referral to SC services through IM	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM
Intervention Group	Active referral to smoking cessation (SC) services	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM
Intervention Group	Regular messages through Instant Messaging (IM)	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM
Control Group	Health warning leaflet	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, SMS message on general health
Control Group	Active referral to smoking cessation (SC) services	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, SMS message on general health
Control Group	Message on general health delivered by short message service (SMS)	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, SMS message on general health
Control Group	AWARD advice	AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, SMS message on general health

Primary Outcome Measures

Name	Time	Method
Biochemically-validated abstinence at 6-month	6-month after baseline	Defined as exhaled carbon monoxide \<4ppm
Biochemically-validated abstinence at 12-month	12-month after baseline	Defined as exhaled carbon monoxide \<4ppm

Secondary Outcome Measures

Name	Time	Method
Self-reported past 7-day abstinence	6-month and 12-month after baseline	Self-reported no cigarette smoking (even a single puff) in the past 7 days
Smoking reduction	6-month and 12-month after baseline	Self-reported reduction in the number of cigarettes smoked daily by at least 50% of the baseline amount
Smoking cessation medication use	6-month and 12-month after baseline	Any use of nicotine replacement therapy from baseline
Self-reported 24-week continuous abstinence	6-month and 12-month after baseline	Self-reported no cigarette smoking (even a single puff) in the past 24 weeks
Smocking cessation services use	6-month and 12-month after baseline	Any use of counselling, hotline, SC clinics and other SC services from baseline
Perceived importance, confidence and difficulties of quitting	6-month and 12-month after baseline	Perceived importance, confidence and difficulties of quitting measured on a scale of 0-10 and a higher score indicates a stronger perception
Intention to quit	6-month and 12-month after baseline	Any intention to quit smoking (yes/no) from baseline
Quit attempts	6-month and 12-month after baseline	Number of quit attempts from baseline

Trial Locations

Locations (1)

School of Nursing, The University of Hong Kong; 🇭🇰 Hong Kong, Hong Kong