Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster randomised clinical trial,Addiction

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Effects of simple active referrals of different intensities on smoking abstinence and smoking cessation services attendance: a cluster randomised clinical trial
Addiction ( IF 5.2 ) Pub Date : 2020-03-25 , DOI: 10.1111/add.15029
Xue Weng ₁ , Tzu Tsun Luk ₁ , Yi Nam Suen ₂ , Yongda Wu ₁ , Ho Cheung William Li ₁ , Yee Tak Derek Cheung ₁ , Antonio Cho Sshing Kwong ₃ , Vienna Wai Yin Lai ₃ , Sophia Siu Chee Chan ₁ , Tai-Hing Lam ₄ , Man Ping Wang ₁

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BACKGROUND AND AIMS Proactive brief cessation advice by a lay counsellor combined with a referral to a smoking cessation service (active referral) is effective in increasing service use and quitting in community smokers. We compared the effect of two modified approaches to referrals on the cessation outcomes in community smokers. DESIGN Three-arm cluster-randomised trial. SETTING General community in Hong Kong. PARTICIPANTS Daily cigarette smokers (n=1163; 77.7% male). INTERVENTIONS Participants were randomised to receive onsite active referral (OSR, n=395), where lay counsellors helped participants make appointments with a smoking cessation service of their choice plus tailored reminders; mobile text messaging referral (TMR, n=385), where participants were encouraged to use a smoking cessation service via text messages; or brief cessation advice only (Control, n=383). MEASUREMENTS The primary outcome was a self-reported 7-day point-prevalence abstinence at 6 months post-treatment initiation. Secondary outcomes included 7-day point-prevalence abstinence at 3 and 18 months, biochemically validated abstinence, smoking reduction and the use of cessation services at 3, 6 and 18 months. FINDINGS Using the intention-to-treat analysis, the OSR (17.7%) and TMR (17.1%) groups had significantly higher self-reported abstinence than the Control (12.0%) group at 6 months (odds ratio [OR] for OSR vs. Control=1.58, 95% confidence interval [CI]=1.06-2.36; OR for TMR vs. Control=1.52, 95% CI=1.01-2.28; both P<0.05). The corresponding validated abstinence rates at 6 months were 7.6%, 7.8% and 3.9% (OR for TMR vs. Control=2.02, 95% CI=1.07-3.81; OR for TMR vs. Control=2.07, 95% CI=1.10-3.92; both P<0.05). Self-reported and validated abstinence were similar at 18 months. OSR groups had higher rates of smoking cessation service use than the Control group at all follow-ups (all P<0.001). The smoking reduction rates were similar in continuing smokers. CONCLUSIONS Simple active referrals (in person or via text messaging) to smoking cessation services increased abstinence rates among smokers in Hong Kong compared with general brief cessation advice. Onsite active referral increased the use of smoking cessation services compared with general brief cessation advice.

更新日期：2020-03-25

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