Decreasing motivation to quit in community recruited smokers in the Quit-To-Win Contest (2009-2016) in Hong Kong

Abstract

Background: The Quit-to-Win Contest (QTW) organized by the Hong Kong Council on Smoking and Health during 2009-2016 (7 rounds, except 2011) provided lottery grand prizes and social support to promote quitting. We examined the trends in socio-demographic characteristics and smoking behaviors of QTW participants. Methods: Smokers (N=7559) were recruited in communities and followed for 6 months. They also participated in randomized control trials built in the QTW testing different quitting interventions (self-help booklet, telephone/on-site face-to-face counseling, short mobile phone messages, uninformed cash incentives, cut-down-to-quit strategy or active referral to cessation services). At baseline, the Heaviness of Smoking Index (HSI) was calculated from daily cigarette consumption and time to 1st cigarette after waking up. Lifetime cessation attempt, planned abstinence day, perceived importance, difficulty and confidence of quitting (measured by a score from 0 to 10) and socio-demographic characteristics were recorded. The non-parametric trend test examined trends socio-demographic characteristics and smoking behaviors. Results: About 20% of participants were female. In 2016, participants being aged 18-29 (30.3%), single (42.6%) and having no children (53.4%), college or above education (23.4%), monthly household income HKD $20,000 or above (43.7%) were more common than previous years (all Ps<0.001). Participants who smoked no more than 10 cigarettes daily and scored 3 or below on HSI increased from 42.4% and 67.2% (2009) to 50.5% and 72.1% (2016), respectively (both Ps<0.001). Meanwhile, participants who had lifetime cessation attempt and planned to quit in 30 days halved from 71.0% and 87.3% to 36.4% and 43.4% (both Ps<0.001). Perceived importance and confidence of quitting dropped from 7.9 ± 2.3 (standard deviation) and 6.2 ± 2.6 (2009) to 6.6 ± 2.2 and 5.1 ± 2.2 (2016), respectively (both Ps<0.05). Conclusions: Participants in recent QTW were younger and less addictive to nicotine, but less had ever tried to quit or were motivated to quit. Future intervention should target these young adult smokers with a low level of addiction but little motivation to quit.