Clinical trial NCT02804880: Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2016
Official title: Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2016: a Single-blind Cluster Randomized Controlled Trial on High Intensity Active Referral and Simple Text Messaging to Achieve Abstinence
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Smoking Cessation
Keywords: Smoking cessation
Quit to Win
Brief intervention
Personalized active referral
Instant messaging
SMS
Smoking Cessation Intervention
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
Collaborators: name: Hong Kong Council on Smoking and Health
First posted: 2016-06-17
Enrollment: 1200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The present study will examine (1) the effectiveness of personalised active referral to smoking cessation (SC) services and text messaging on encouraging SC services (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, process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.

Detailed description: Although smoking prevalence is decreasing in Hong Kong, there are still 641,300 daily smokers (10.5%; Census and Statistics Department, 2015) and half will be killed by smoking (Lam, 2012) which accounts for over 7,000 deaths per year (Lam, Ho, Hedley, Mak, \& Peto, 2001). 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) (Census \& Statistics Department, 2001; McGhee et al., 2006) . 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 (Cahill \& Perera, 2011). 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 (Cahill \& Perera, 2015).

Smoking cessation services in Hong Kong are under-used with most of the adult daily smokers (79.6%) who had never used smoking cessation services (Census and Statistics Department, 2015). Among these smokers, only 2.4% were willing to use the services. Our previous RCT in previous QTW Contest 2015 evaluated the effects of low-intensity active referral (LAR) vs. very brief general SC advice (VBA) on quitting. LAR included onsite AWARD counselling and collection of smokers' personal contact information for SC services providers to connect with the smokers. Findings at 3-month follow-up of this RCT suggested the LAR intervention resulted in significantly higher self-reported quit rate than VBA in the control group (18.7% vs 14.0%. P\<0.001).

It is warranted to evaluate if a higher intensity active referral (HAR) and/or text messaging on encouraging SC services use can achieve even higher quit rate when compared with only VBA is given in the control group. Noted the use of text-messaging is the cheaper method than HAR. By using the same design of control group in QTW 2015, we can combine and compare the 2 years QTW intervention of HAR, LAR and text-messaging using network meta-analysis. This will contribute to finding out a more cost-effective way to increase the quit rate through using SC services.

Therefore, the present study will examine (1) the effectiveness of personalised active referral to smoking cessation (SC) services and text messaging on encouraging SC services (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, 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
* Exhaled carbon monoxide (CO) 4 ppm or above, assessed by a validated CO smokerlyzer
* Have Intention to quit / reduce smoking

Exclusion Criteria:

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

Primary outcomes:
measure: smoking quit rate change from baseline at 3-month follow-up
timeFrame: 3-month follow-up
measure: smoking quit rate change from baseline at 6-month follow-up
timeFrame: 6-month follow-up
Secondary outcomes:
measure: Biochemical validated quit rate
timeFrame: 3-month follow-up
measure: Biochemical validated quit rate
timeFrame: 6-month follow-up
measure: Smoking reduction rate change from baseline at 3-month follow-up
timeFrame: 3-month follow-up
measure: Smoking reduction rate change from baseline at 6-month follow-up
timeFrame: 6-month follow-up
measure: Smoking quit attempt change from baseline at 3-month follow-up
timeFrame: 3-month follow-up
measure: Smoking quit attempt change from baseline at 6-month follow-up
timeFrame: 6-month follow-up
measure: quit rate for all subjects change from baseline at 3- and 6-month follow-up
timeFrame: 3 and 6 months follow-up
measure: Reduction rate for all subjects change from baseline at 3- and 6-month follow-up
timeFrame: 3 and 6 months follow-up
measure: Use of smoking cessation service
timeFrame: 3 and 6 months follow-up
measure: Use of smoking cessation service for all subjects
timeFrame: 3 and 6 months follow-up
Other outcomes:
Locations:
city: Hong Kong
country: China
facility: The Hong Kong Council on Smoking and Health (COSH)
Study officials:
affiliation: The University of Hong Kong
name: Man Ping Kelvin Wang, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Weng X, Wang MP, Suen YN, Li WHC, Wu Y, Cheung DYT, Kwong ACS, Lai VWY, Chan SSC, Lam TH. Comparing different intensities of active referral to smoking cessation services in promoting smoking cessation among community smokers: a study protocol of a cluster randomized controlled trial. BMC Public Health. 2018 Jul 4;18(1):830. doi: 10.1186/s12889-018-5782-1.