Proactive Minimal Cessation Advice plus Nicotine replacement therapy (PMCAN) for smoking cessation in smokers at smoking hotspots: a pilot randomized controlled trial

Dr Wang, Man Ping   (Principal Investigator (PI))

Emeritus Professor Lam Tai Hing   (Co-Investigator)

Dr Li William Ho Cheung   (Co-Investigator)

Dr Suen Yi Nam   (Co-Investigator)

5

2016-07-01

39000

Proactive Minimal Cessation Advice plus Nicotine replacement therapy (PMCAN) for smoking cessation in smokers at smoking hotspots: a pilot randomized controlled trial

Active referral, Brief cessation advice, Nicotine replacement therapy, Randomized controlled trial, Smoking cessation

Population Health,Epidemiology

N/A

Seed Fund for Basic Research for Resubmission of GRF/ECS Proposals

2016

Completed

This pilot 4-arm randomized controlled trial (RCT) is to assess the effect of the Proactive Minimal Cessation Advice and NRT intervention (PMCAN) delivered by trained health care student helpers for promoting smoking cessation among smokers at the smoking hotspots. Many smokers cannot quit due to nicotine withdrawal symptoms, which peak at the first week of abstinence. Proactive recruitment of smokers is needed as most smokers do not seek smoking cessation (SC) services. A smoking hotspot (SH) is defined as a public outdoor place where smokers stop/linger and smoke. We aim to include a reasonably ""representative"" or unbiased sample of SH at different locations from all 3 regions of Hong Kong. We will randomly select 6 eligible SH (2 in each regions) from the 15 hotspots in our previous community trial. Two trained SC ambassadors (student helpers) and one supervisor (experienced research assistant) will be deployed for each session of intervention at a SH. Potential subjects will be approached using the ""a-foot-into-the-door"" method in which SC ambassador will ask if smoker would like to reduce/quit smoking and receive SC intervention or advices. This procedure had ethical approval (IRB no. UW15-232) and was used in our pilot RCT (NCT02491086). Smokers will be assessed for eligibility and informed written consent will be sought. Subjects will complete a brief self-administered questionnaire (baseline) using tablet PC (please refer to Measurement). To reduce later hang-ups of telephone interventions or surveys, SC ambassador will save contact number of the trial into subjects’ mobile phones. Smokers who are willing to join the trial regardless of their intention to stop or reduce smoking will be recruited by trained (1-day training) student helpers and individually randomly allocated (with allocation concealment) to any 1 of the 4 groups (n=8 each; n=32 in total). The information of each group is shown below: Components Group A B C D 1-week free NRT + NRT usage card √ √ Minimal advice using AWARD model (1-minute)* √ √ Health warning leaflet √ √ √ √ *AWARD model: Ask, Warn, Advise, Refer, Do-it-again (using a standard script delivered by trained student helpers) Primary outcomes are exhaled CO validated abstinence at 3-month. Major secondary outcomes include self-reported past 7-day point prevalence abstinence, nicotine addiction level, quit intention and attempts, smoking reduction, NRT and SC service use at 3-month follow-up. Outcome assessors will be blinded to group allocation. We will follow the CONSORT strictly. The findings will provide much needed and original evidence to support a main RCT on these new, proactive, simple and low-cost interventions for improving current SC services and policy for smokers who do not actively seek help from SC services in Hong Kong and elsewhere.