Effectiveness of promoting smoking cessation through the Quit to Win Contest in Hong Kong: The 6-month follow up of a randomized controlled trial

Abstract

INTRODUCTION: In 2009, a Quit to Win Contest was held in Hong Kong to attract the community to quit smoking. In this study, we aimed to assess the effectiveness of using proactive telephone brief advice, SMS messages, and self-help materials to help contestants quit smoking. METHODS: The study recruited 1,119 daily smokers from shopping malls and housing estates throughout HK. 1,003 smokers who had mobile phone to receive SMS were consented and randomly allocated into 3 groups: TEL group, n=338; SMS group, n=335; CONTROL group, n=330. After recruitment, subjects in the TEL group received a 5-mins call from a cessation counselor within 7 days while SMS group received 8 SMS text messages within 1 month, both contents included quit advice with specific health hazard warnings and hotlines. All subjects received a self-help quitting guide. RESULTS: Most subjects were male (82%); 72% were in middle age (30-59 years) and 13% were elderly (≥ 60 years). Most subjects (72%) started smoking before the age of 20 and 33% smoked heavily according to the Heaviest of Smoking Index (HSI). During the recruitment, 66% subjects intended to quit in the next 7 days. Similar profiles were found in the 3 groups (P-values ranged from 0.38 to 0.94). All subjects were followed up at 6-month and the overall response rate was 70%. By intention to treat, the quit rate (7-day point prevalence) was 22.2% in the TEL group and 20.5% in the pooled SMS and control group (P=0.52). Overall, 55% in the TEL group and 58.9% in the pooled SMS and CONTROL group reduced their cigarette consumption and/or had made a quit attempt at 6-month follow up (P=0.24). CONCLUSIONS: The Contest successfully captured the interest and attracted many older smokers to quit. In general, the Quit to Win Contest (21%) achieved a higher quit rate as compared to a pilot adult-Quitline in HK (12%). Additional brief telephone counseling on smoking health hazards seems to have some impacts to help people quit smoking and regulate their smoking behaviors. Since the project is still in the progress of 12-month follow-up, the long-term effect of the two additional smoking cessation approaches still need to be further confirmed.