COVID-19 Brief Advice and Chat-based Support for Smoking Cessation Via "Quit to Win" Contest 2020

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1166 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-13

Study Completion Date

2022-06-30

Brief Summary

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The present study will examine (1) the effectiveness of a combined brief advice and personalized chat-based support on COVID-19 related smoking messages 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.

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Detailed Description

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Smoking is detrimental to the immune system and can cause respiratory tract infection. Growing evidence has suggested that compared to non-smokers, COVID-19 patients who have a history of smoking are at a higher risk of developing severe respiratory and cardiovascular symptoms, consequently may require mechanical ventilation and intensive care. A case series of 1,099 COVID-19 patients in China has found that ever smokers, compared with never smokers, were more likely to have severe COVID-19 disease upon hospital admission and be admitted to intensive care unit, need to use mechanical ventilation, and die. The result is corroborated by a multivariable analysis of 78 COVID-19 pneumonia cases in China, which identified smoking as the only preventable risk factor for disease progression. While the link between smoking and the COVID-19 needs further research, smokers appear to be at a greater risk of suffering from serious symptoms due to COVID-19.

The practice of smoking might also predispose smokers to COVID-19 infection. Smoking behavior is characterized by inhalation and the hand-to-mouth movements which increase the possibility of transmission of virus from contaminated fingers and cigarettes to mouth. In Hong Kong, where smoking is banned in indoor public areas and workplace, smokers often gather and smoke at smoking hotspots outdoor, where ashtrays are available. This increases their risk of infection since the smokers are in close contact with each other and have to remove their mask to smoke. Exhaling smoke also aids the spreading the virus in the air. However, misleading information that smoking can prevent COVID-19 infection is widespread on social media.

Public health strategies (e.g., social distancing, staying at home and working from home) may motivate some smokers to reduce or to quit smoking due to the inconvenience to smoke indoor and to buy cigarettes from retail outlets. However, home confinement may result in social isolation and psychological distress (anxiety and stress) both increasing the need for smoking. Some smokers who are not used to smoke at home might be prompted to smoke at home to cope with their craving during lockdown or work from home, which may also expose their family members from second-hand smoke.

Our RCT in QTW Contest 2017 evaluated the effectiveness of a chat-based intervention delivered through a mobile instant messaging application (WhatsApp) plus active referral to SC services to increase quitting. Chat-based intervention resulted in higher abstinence rate compared with the control group at 6-month follow-up. In QTW Contest 2019, we evaluated the effectiveness of a combined intervention of AWARD advice, active referral, instant messaging and optional cocktail intervention to increase abstinence. The preliminary result showed that the personalized instant messaging (PIM) group and regular instant messaging (RIM) group had similar abstinence rate at 6-month follow-up.

Therefore, the present study will examine (1) the effectiveness of a combined brief advice and personalized chat-based support on COVID-19 related smoking messages 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.

Conditions

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Smoking Cessation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention Group

Chat-based support+ COVID-19 specific advice + AWARD advice + COVID-related health warning leaflet + referral card + COSH booklet

Group Type EXPERIMENTAL

Chat-based support

Intervention Type BEHAVIORAL

Participants will receive three months of chat-based support through IM apps (e.g. WhatsApp, WeChat). The regular messages and instant messaging on psychosocial support aim to provide hygienic advice to reduce the risk of exposure to SARS-cov2, increase self-efficacy and confidence, and social support and behavioral capacity of quitting.

AWARD plus COVID-specific advice

Intervention Type BEHAVIORAL

Ask about smoking history, Warn about the risks associated with the COVID-19 and smoking (with a COVID-related health warning leaflet), Advise to quit as soon as possible during the COVID-19 pandemic, Refer smokers to SC services (with a referral card, see below for information), and Do it again: to repeat the intervention

COVID-19 related health warning leaflet

Intervention Type BEHAVIORAL

The 2-sided color printed A4 leaflet, which covers the risk of COVID-19 and smoking and the most important messages to motivate smoking cessation

Referral card

Intervention Type BEHAVIORAL

The 3-folded "Smoking Cessation Services" card consists of brief information and highlights of existing smoking cessation services, contact methods, motivation information and strong supporting messages or slogans.

COSH Self-help smoking cessation booklet

Intervention Type BEHAVIORAL

A general smoking cessation self-help booklet

Control Group

Text-based support + AWARD advice + warning leaflet + referral card + COSH booklet

Group Type EXPERIMENTAL

AWARD advice

Intervention Type BEHAVIORAL

Ask about smoking history, Warn about the high risk of smoking, Advise to quit as soon as possible, Refer to the smoking cessation services, and Do it again (if the smokers refused to set quit date).

Health warning leaflet

Intervention Type BEHAVIORAL

The 2-sided color printed A4 leaflet, which systematically covers the most important messages to motivate smoking cessation.

SMS-based support

Intervention Type BEHAVIORAL

Participants will receive regular SMS with similar frequency to Intervention group but with generic information on smoking cessation.

Referral card

Intervention Type BEHAVIORAL

The 3-folded "Smoking Cessation Services" card consists of brief information and highlights of existing smoking cessation services, contact methods, motivation information and strong supporting messages or slogans.

COSH Self-help smoking cessation booklet

Intervention Type BEHAVIORAL

A general smoking cessation self-help booklet

Interventions

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Chat-based support

Participants will receive three months of chat-based support through IM apps (e.g. WhatsApp, WeChat). The regular messages and instant messaging on psychosocial support aim to provide hygienic advice to reduce the risk of exposure to SARS-cov2, increase self-efficacy and confidence, and social support and behavioral capacity of quitting.

Intervention Type BEHAVIORAL

AWARD plus COVID-specific advice

Ask about smoking history, Warn about the risks associated with the COVID-19 and smoking (with a COVID-related health warning leaflet), Advise to quit as soon as possible during the COVID-19 pandemic, Refer smokers to SC services (with a referral card, see below for information), and Do it again: to repeat the intervention

Intervention Type BEHAVIORAL

AWARD advice

Ask about smoking history, Warn about the high risk of smoking, Advise to quit as soon as possible, Refer to the smoking cessation services, and Do it again (if the smokers refused to set quit date).

Intervention Type BEHAVIORAL

COVID-19 related health warning leaflet

The 2-sided color printed A4 leaflet, which covers the risk of COVID-19 and smoking and the most important messages to motivate smoking cessation

Intervention Type BEHAVIORAL

Health warning leaflet

The 2-sided color printed A4 leaflet, which systematically covers the most important messages to motivate smoking cessation.

Intervention Type BEHAVIORAL

SMS-based support

Participants will receive regular SMS with similar frequency to Intervention group but with generic information on smoking cessation.

Intervention Type BEHAVIORAL

Referral card

The 3-folded "Smoking Cessation Services" card consists of brief information and highlights of existing smoking cessation services, contact methods, motivation information and strong supporting messages or slogans.

Intervention Type BEHAVIORAL

COSH Self-help smoking cessation booklet

A general smoking cessation self-help booklet

Intervention Type BEHAVIORAL

Other Intervention Names

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Ask, Warn, Advise, Refer, Do-it-again Ask, Warn, Advise, Refer, Do-it-again Brief leaflet on health warning and smoking cessation Smoking Cessation Service Card

Eligibility Criteria

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Inclusion Criteria

* Hong Kong residents aged 18 or above
* Smoke at least 1 tobacco stick per day or use e-cigarette daily in the past 3-month
* Able to communicate in Cantonese (including reading Chinese)
* Saliva cotinine 30 ng/ml or above
* Intent to quit / reduce smoking
* Able to use instant messaging tool (e.g., WhatsApp, WeChat) for communication.

Exclusion Criteria

* Smokers who have communication barrier (either physically or cognitively)
* Smokers who are currently participating in other SC programmes or services

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No