Man Ping Wang1, William H Li1, Yee Tak Cheung1,2, Oi Bun Lam1, Yongda Wu1, Antonio C Kwong3, Vienna W Lai3, Sophia S Chan1, Tai Hing Lam2. 1. School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China. 2. School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China. 3. Hong Kong Council on Smoking and Health, Hong Kong Special Administrative Region, People's Republic of China.
Abstract
AIMS: To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking. METHODS: Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment. RESULTS: By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months. CONCLUSIONS: Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence. IMPLICATIONS: This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.
AIMS: To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking. METHODS: Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment. RESULTS: By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months. CONCLUSIONS: Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence. IMPLICATIONS: This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.
Authors: Man Ping Wang; Yi Nam Suen; William Ho-Cheung Li; Christina Oi-Bun Lam; Socrates Yong-da Wu; Antonio Cho-Shing Kwong; Vienna W Lai; Sophia S Chan; Tai Hing Lam Journal: JAMA Intern Med Date: 2017-12-01 Impact factor: 21.873
Authors: Socrates Yong-da Wu; Man Ping Wang; William H Li; Antonio C Kwong; Vienna W Lai; Tai Hing Lam Journal: Int J Environ Res Public Health Date: 2018-02-26 Impact factor: 3.390
Authors: Xue Weng; Man Ping Wang; Yi Nam Suen; William Ho Cheung Li; Yongda Wu; Derek Yee Tak Cheung; Antonio Cho Shing Kwong; Vienna Wai Yin Lai; Sophia Siu Chee Chan; Tai Hing Lam Journal: BMC Public Health Date: 2018-07-04 Impact factor: 3.295
Authors: Ka Yan Ho; William Ho Cheung Li; Katherine Ka Wai Lam; Man Ping Wang; Wei Xia; Lok Yin Ho; Kathryn Choon Beng Tan; Hubert Kit Man Sin; Elaine Cheung; Maisy Pik Hung Mok; Tai Hing Lam Journal: BMJ Open Date: 2018-12-19 Impact factor: 2.692
Authors: Xue Weng; Yongda Wu; Tzu Tsun Luk; William Ho Cheung Li; Derek Yee Tak Cheung; Henry Sau Chai Tong; Vienna Lai; Tai Hing Lam; Man Ping Wang Journal: Lancet Reg Health West Pac Date: 2021-07-05
Authors: William Ho Cheung Li; Ka Yan Ho; Man Ping Wang; Derek Yee Tak Cheung; Katherine Ka Wai Lam; Wei Xia; Kai Yeung Cheung; Carlos King Ho Wong; Sophia Siu Chee Chan; Tai Hing Lam Journal: JAMA Intern Med Date: 2020-02-01 Impact factor: 21.873
Authors: Xue Weng; Man Ping Wang; Ho Cheung William Li; Yee Tak Derek Cheung; Ching Yin Lau; Antonio Cho Shing Kwong; Vienna Wai Yin Lai; Sophia Siu Chee Chan; Tai Hing Lam Journal: BMJ Open Date: 2020-10-26 Impact factor: 2.692