Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

Weng, Xue; Wang, Man Ping; Cheung, Yee Tak Derek; Lau, Ching Yin; Kwong, Antonio; Lai, Vienna; Chan, Sophia Siu Chee; Lam, Tai Hing

doi:10.1136/bmjopen-2020-038351

Cited by 3 publications

(3 citation statements)

References 31 publications

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“… 10 , 11 , 17 , 23 , 24 The trial protocol approved by the Institutional Review Board (IRB) of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW18–318) has been registered with ClinicalTrials.gov ( NCT03565796 ) and published elsewhere. 25 Consolidated Standards of Reporting Trials (CONSORT) reporting guideline was followed.…”

Section: Methodsmentioning

confidence: 99%

Active referral plus a small financial incentive upon cessation services use on smoking abstinence: a community-based, cluster-randomised controlled trial

Weng

Luk

et al. 2021

The Lancet Regional Health - Western Pacific

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Background: Many smokers do not use existing free or low-cost smoking cessation services, cost-effective interventions to increase use are needed. Methods:We did a 2-armed cluster randomised controlled trial (cRCT) in Hong Kong, China, to evaluate the effectiveness of active referral plus a small financial incentive on abstinence. Chinese adult smokers who smoked at least 1 cigarette per day were proactively recruited from 70 community sites (clusters). Random allocation was concealed until the recruitment started. The intervention group received an offer of active referral to cessation services at baseline plus an incentive (HK$300/US$38) after using any cessation services within 3 months. The control group received general brief cessation advice. The primary outcomes were biochemically validated abstinence at 3 and 6 months. Operating costs in real-world implementation was calculated. Trial Registry: ClinicalTrials.gov NCT03565796 .Findings: Between June and September 2018, 1093 participants were randomly assigned to the intervention (n = 563) and control (n = 530) groups. By intention-to-treat, the intervention group showed higher validated abstinence than the control group at 3 months (8.4% vs. 4.5%, risk ratio [RR] 1.88, 95% CI 1.01-3.51, P = 0.046) and 6 months (7.5% vs. 4.5%, RR 1.72, 95% CI 1.01-2.93, P = 0.046). Average cost per validated abstinence was lower in the intervention (US$ 421) than control (US$ 548) group.Interpretation: This cRCT has first shown that a simple, brief, and low-cost intervention with active referral plus a small monetary incentive was effective in increasing smoking abstinence and smoking cessation service use in community smokers.

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Section: Methodsmentioning

confidence: 99%

Active referral plus a small financial incentive upon cessation services use on smoking abstinence: a community-based, cluster-randomised controlled trial

Weng

Luk

et al. 2021

The Lancet Regional Health - Western Pacific

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“…Survey 2 was a telephone survey conducted from 7 May to 30 June 2020, including subjects who formerly participated in the 'Quit to Win' project for smokers in 2018 and 2019 (organized annually by the Hong Kong Council on Smoking and Health in collaboration with us). The 'Quit to Win' project has been reported elsewhere 32,33 . Among the 968 people invited, 769 (79.4%) agreed to participate.…”

Section: Data Collectionmentioning

confidence: 99%

Changes in tobacco use at the early stage of the COVID-19 pandemic: Results of four cross-sectional surveys in Hong Kong

Sun¹,

Wang²,

Cheung³

et al. 2022

Tob. Induc. Dis.

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INTRODUCTION Changes in tobacco use since the COVID-19 outbreak differed by countries and little is known about changes in the use of specific tobacco products. METHODS We analyzed data from four cross-sectional telephone/online surveys from April to June 2020 to investigate such changes since the 1st and 2nd wave outbreaks (February to April 2020) in Hong Kong. The respondents were 1595 adults (83.2% male) who used tobacco before the COVID-19 outbreak from our previous intervention study and surveys. We investigated the changes in tobacco use, intention to quit and quit attempts during the outbreak. RESULTS About two-thirds (65.3%) of respondents reported no change in overall tobacco use, while 23.1% used less (including cessation) and 11.6% used more, resulting in a net decrease of 11.5 percentage points. A greater net decrease was observed for cigarettes (14.3% points) than heated tobacco products (HTPs, 3.3% points) and electronic cigarettes (e-cigarettes, 2.5% points). Decreased use was mainly due to the more extended stay at home (63.2%), health considerations (52.6%) and mask-wearing (47.4%), while increased use was for passing time (75.0%) and releasing stress (46.4%). Eight percent of cigarette, HTP and e-cigarette users reported a higher intention to quit since the pandemic outbreak. Nineteen percent of tobacco users (176/948) attempted to quit during the pandemic. Only 2.9% (46/1569) were abstinent at the time of the survey. CONCLUSIONS Overall tobacco use decreased after the first two waves of the COVID-19 outbreak in Hong Kong. A greater proportion of cigarette users decreased use than HTP and e-cigarette users. Given the different methods used in the four surveys, future studies should aim for a large and representative sample.

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“…Our previous trial showed active referral plus a small monetary incentive was effective in increasing smoking cessation service use and abstinence [ 36 ]. To promote smoking cessation service use, participants who are verbally committed to using any smoking cessation services within 2 months will receive a pre-paid monetary incentive (HK$100, ≈ US$ 12.8) by post.…”

Section: Methodsmentioning

confidence: 99%

Adaptive interventions to optimise the mobile phone-based smoking cessation support: study protocol for a sequential, multiple assignment, randomised trial (SMART)

Zhao

Weng

Luk

et al. 2022

Trials

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Background Mobile health (mHealth) is promising in developing personalised smoking cessation interventions. By using an adaptive trial design, we aim to evaluate the effectiveness of personalised mHealth intervention in increasing smoking cessation. Methods This study is a two-arm, parallel, accessor-blinded Sequential Multiple-Assignment Randomised Trial (SMART) that randomises 1200 daily cigarette smokers from 70 community sites at two timepoints. In the first phase, participants receive brief cessation advice plus referral assistance to smoking cessation services and are randomly allocated to receive personalised instant messaging (PIM) or regular instant messaging (RIM). In the second phase, PIM participants who are non-responders (i.e. still smoking at 1 month) are randomised to receive either optional combined interventions (multi-media messages, nicotine replacement therapy sampling, financial incentive for active referral, phone counselling, and family/peer support group chat) or continued-PIM. Non-responders in the RIM group are randomised to receive PIM or continued-RIM. Participants who self-report quitting smoking for 7 days or longer at 1 month (responders) in both groups continue to receive the intervention assigned in phase 1. The primary outcomes are biochemical abstinence validated by exhaled carbon monoxide (< 4 ppm) and salivary cotinine (< 10 ng/ml) at 3 and 6 months from treatment initiation. Intention-to-treat analysis will be adopted. Discussion This is the first study using a SMART design to evaluate the effect of adaptive mHealth intervention on abstinence in community-recruited daily smokers. If found effective, the proposed intervention will inform the development of adaptive smoking cessation treatment and benefits smokers non-responding to low-intensity mHealth support. Trial registration ClinicalTrials.govNCT03992742. Registered on 20 June 2019.

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Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

Cited by 3 publications

References 31 publications

Active referral plus a small financial incentive upon cessation services use on smoking abstinence: a community-based, cluster-randomised controlled trial

Active referral plus a small financial incentive upon cessation services use on smoking abstinence: a community-based, cluster-randomised controlled trial

Changes in tobacco use at the early stage of the COVID-19 pandemic: Results of four cross-sectional surveys in Hong Kong

Adaptive interventions to optimise the mobile phone-based smoking cessation support: study protocol for a sequential, multiple assignment, randomised trial (SMART)

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