Helping cancer patients quit smoking using brief advice based on risk communication: A randomized controlled trial

Abstract

This randomized controlled trial aimed to examine the effectiveness of a smoking cessation intervention using a risk communication approach. A total of 528 smoking cancer patients were randomly allocated either into an intervention group (n = 268) to receive brief advice based on risk communication by a nurse counselor or a control group (n = 260) to receive standard care. Subjects in both groups received a smoking cessation booklet. Patient follow-ups were at 1 week and at 1, 3, 6, 9 and 12 months. No significant differences were found in self-reported point-prevalence 7-day abstinence between the intervention and control groups at 6 months (15.7% vs 16.5%; OR 0.94, 95% CI 0.59–1.50). The rate of at least 50% self-reported reduction of smoking at 6 months, was higher in the intervention group than in the control group (16.8% vs 12.3%; OR 1.43, 95% CI 0.88–2.35). The biochemically validated quit rate at the 6-month follow-up was higher in the intervention group than in the control group (5.2% vs 3.8%; OR 1.38, 95% CI 0.60–3.16). These data suggest that advice based on risk communication was not effective for quitting but improved the rate of smoking reduction among smoking cancer patients.

Effectiveness of a Brief Self-determination Theory–Based Smoking Cessation Intervention for Smokers at Emergency Departments in Hong Kong

“…Participants' baseline data, including demographic characteristics, health status, and smoking history, were obtained using a structured questionnaire based on previous trials. 17,18 The questionnaires were administered face-to-face by a trained research assistant before randomization.…”

“…A structured standardized questionnaire was developed by adopting and modifying international and locally validated instruments from previous trials. 17,18 Participants' self-efficacy against tobacco was assessed by the SEQ-12, which is a valid and reliable scale that has been used in both research and clinical settings with Chinese populations in Hong Kong. 19 The health utility score was measured with the SF-6D, which reflects the level of physical, mental, and social functioning associated with a particular health state, as well as the preference weight that the general population gives to that health state.…”

“…Most existing cessation programs, including stagematched interventions and motivational interviewing, generally require implementation time exceeding 30 minutes, which is often not feasible in busy clinical settings. Previous smoking cessation RCTs 17,18,33 in outpatient clinics revealed that many patients were unwilling to undergo a long intervention by nonphysicians, and some were reluctant to participate for fear of missing or delaying their medical consultation. Moreover, because of the busy clinical environment and lack of training on smoking cessation, many health care professionals were hesitant to help smokers quit.…”

“…Previous smoking cessation trials in outpatient clinics in Hong Kong reported that approximately 70% of smokers had no intention to quit. 17,18,33 A possible reason for the low participation rate in our trial was that most eligible participants had no interest in quitting and were thus reluctant to partici-pate in a smoking cessation project. The response rate was similar to that of a previous trial on smoking cessation conducted in clinics.…”

“…The response rate was similar to that of a previous trial on smoking cessation conducted in clinics. 18 To enhance the generalizability of the findings, we conducted participant recruitment at 4 major acute-care hospitals among different districts of Hong Kong, in which most emergency patients can be approached. Second, our retention rate of 68.5% (1076 of 1571) was similar to that of other smoking cessation trials, which usually had retention rates of approximately 70%.…”