Promotion and brief intervention of smoking cessation at the smoking hotspots

Abstract

BACKGROUND: Promoting smoking cessation in the community is essential to motivate more smokers to quit and reduce smoking prevalence. The study aimed to examine the feasibility of promoting smoking cessation at smoking “hotspots” - the outdoor areas with many smokers who gather to smoke and a rubbish bin for cigarette butts’ disposal. A total of 14 hotspots located at bus stops, entrances of commercial buildings and shopping malls were selected for the observation and delivery of brief intervention. METHODS: Two half-day training sessions were organized to deliver knowledge of tobacco control and counseling skills to 40 undergraduate student ambassadors. They proactively approached the smokers to deliver souvenirs (a pack of tissue which showed quitting advice to attract smokers), measure their exhaled carbon monoxide level, deliver brief advice (about 5 minutes) and invite them to receive telephone follow-up. The brief advice was a well-structured protocol using AWARD model, including asking the smoking status, warning about smoking harms, advising on quitting, referring to telephone follow-up and do-it-again by repeating the advice again. No cessation medication was provided, but the participants could obtain free NRT from the smoking cessation clinics. RESULTS: In the 108-hour intervention sessions from January to August 2015, 3,096 smokers were approached and 1,285 of them (41.5%) accepted our souvenirs. The ‘AWARD’ advice was delivered to 916 smokers, in which 430 (46.9%) received the complete advice. 210 smokers consented to accepting further telephone follow-up, while 60.0% of them (n=126) were successfully contacted at 1-week follow-up. In the smokers who were successfully contacted at 6-month follow-up (n=109), 16 (14.8%) had quitted smoking, and 9 (8.3%) reported reduction of their cigarette consumption by at least 50%. Among those who continued to smoke (n=92), 12.4% had attempted abstinence for at least 24 hours and 71.7% had intention to quit at 6-month follow-up. CONCLUSIONS: The findings show the feasibility and preliminary effectiveness of promoting smoking cessation and delivering brief intervention to the smokers at smoking hotspots. Smoking hotspot can be developed as an important channel for promotion and intervention of smoking cessation.