Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2018

The present study will examine (1) the effectiveness of a combined intervention of face-to-face brief cessation advice (AWARD), active referral of SC service plus financial incentive on encouraging SC services use and (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, a process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.

Although smoking prevalence is decreasing in Hong Kong, there are still 615,000 daily cigarette smokers in Hong Kong in 2017 and half will be killed by smoking which accounts for over 7,000 deaths per year. Smoking also accounts for a large amount of medical cost, long-term care and productivity loss of US$688 million (0.6% Hong Kong GDP). Smoking is a highly addictive behavior and it is difficult for smokers with strong nicotine dependence to quit without assistance. On the other hand, reaching and helping the many smokers who have no intention to quit is a challenge, because they are unlikely to seek professional help from smoking cessation services.

The Quit and Win programme provides an opportunity to reach and encourage a large group of smokers to make quit attempt and maintain abstinence. The Quit and Win model posits that smokers participating in the contest will have higher motivation to quit with incentives and better social support. Studies have found that such quitting contests or incentive programs appeared to reach a large number of smokers and demonstrated a significantly higher quit rate for the quit and win group than for the control group.

SC services utilization rates are markedly low in Hong Kong. The latest Thematic Household Survey reported that only 3.3% daily smokers had ever used SC services. Among never-used smokers, only 3.1% of them were willing to try the SC services. The previous trial in QTW Contest 2016 depicts a similar pattern. Despite over three quarters of participants (77.0%) in the HAR group had chosen an SC service. Among them, only a small percentage (34.9%) actually used the SC service. Most smokers (65.1%) failed to attend the SC service under the HAR intervention. Consequently, better interventions are needed to extend the reach of SC services and smokers who had chosen an SC service but fail to attend.

The previous trial in QTW Contest 2013 showed a small cash incentive with early notifications increased quit attempt by self-directed help, but it did not increase abstinence and the use of formal cessation aids. Therefore, financial incentive-based SC programme focusing on promoting existing SC services use is warranted.

Therefore, the present study will examine (1) the effectiveness of a combined intervention of face-to-face brief cessation advice (AWARD), active referral of SC service plus financial incentive on encouraging SC services use and (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, a process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.

Eligibility Criteria:
Inclusion Criteria:

* Hong Kong residents aged 18 or above
* Smoke at least 1 cigarette per day in the past 3 months
* Able to communicate in Cantonese (including reading Chinese)
* Exhaled carbon monoxide (CO) 4 ppm or above, assessed by a validated CO smokerlyzer
* Intent to quit / reduce smoking

Exclusion Criteria:

* Smokers who have difficulties (either physical or cognitive condition) to communicate
* Currently following other smoking cessation programs