A randomized control trial on smoking cessation intervention with nicotine replacement therapy on patients with erectile dysfunction in Hong Kong

Abstract

Background: Smoking can cause erectile dysfunction (ED) and ED patients have a high risk of coronary heart disease. We conducted an RCT on the effectiveness of a smoking cessation intervention among Chinese ED patients. Methods: Chinese ED patients aged 18 or above, smoking at least 1 cigarette daily, intending to quit within 7 days and accepting NRT, were included. Subjects were randomly allocated into 2 intervention (A1 and A2) groups and one control group. A1 group received a 3-minute brief adherence counseling in addition to a 15-minute smoking cessation counseling emphasizing on the relationship between smoking, quitting and ED and free supply of NRT at baseline and 1-week provided by a trained male counselor; whereas, A2 group received the same intervention as A1 but with no adherence counseling. The control group received a 10-minute brief cessation counseling. We followed up all subjects at 6-month via telephone. We combined A1 and A2 and compared with the control group in the present analysis. All self-reported quitters at 6-month follow up were invited for urinary cotinine and exhaled carbon monoxide validation of tobacco use. Results: 719 subjects were recruited from January 2004 to April 2007 with 249 in A1, 252 in A2 and 218 controls. Of all the subjects, 50% (362) were aged 30-50 years, 37% (267) had severe nicotine dependency, 25% (180) took ED medication, and 33% (239) had severe ED when not taking medication. By intention-totreat, at 6-month follow up, the self-reported and biochemically confirmed quit rates in the intervention groups were significantly higher than those in the control group (self-reported: 23.0% vs, 12.8%, P<0.001; biochemically confirmed: 11.4% vs. 5.5%, P=0.013). More subjects in the intervention groups had reduced cigarette consumption by at least half (42.5% vs. 28.0%, P<0.01) than the control group. Conclusions: The intervention was effective for quitting and reduction in cigarette consumption among Chinese ED patients. The result provides strong evidence to support smoking cessation intervention as part of standard care for smoking ED patients. This study was funded by Research Grant Council, Hong Kong (HKU7428/03M).