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This study aims to assess the effect of personalized support using instant messaging application on smoking cessation in smokers proactively recruited from smoking hotspots in Hong Kong.
Detailed Description: With the advancement of information communication technologies (ICTs), instant messaging applications (IM Apps, e.g. WhatsApp and WeChat) can be used for providing synchronous, personalized, interactive interventions for health promotion. This study proposes to apply IM Apps for enhancing our tested brief smoking cessation (SC) intervention model from AWARD to e-AWARD (AWARD: Ask, Warn, Advise, Refer, Do-it-again,) without medications to increase SC in smokers proactively recruited in smoking hotspots in Hong Kong. Such smokers are the majority and have low quit rate. IM Apps allows trained SC advisors to proactively deliver personalized SC advices, response to smokers' needs promptly, and provide psychosocial support. No similar trials are found in PubMed, Cochrane Library and trial registries (ClinicalTrials.gov & ISRCTN) (except the pilot trial of this study). The aims of this study are as follows:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, regular messages through Instant Messaging (IM), psychosocial support and referral to SC services through IM |
|
| Control Group | Active Comparator | AWARD advice, health warning leaflet, active referral to smoking cessation (SC) services, SMS message on general health |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AWARD advice | Behavioral | At baseline, brief smoking cessation advice following AWARD model will be delivered to subjects within about 2 to 5 minutes:
|
| Measure | Description | Time Frame |
|---|---|---|
| Biochemically-validated abstinence at 6-month | Defined as exhaled carbon monoxide <4ppm | 6-month after baseline |
| Biochemically-validated abstinence at 12-month | Defined as exhaled carbon monoxide <4ppm | 12-month after baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported past 7-day abstinence | Self-reported no cigarette smoking (even a single puff) in the past 7 days | 6-month and 12-month after baseline |
| Self-reported 24-week continuous abstinence |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fleur Lee, MPhil | Contact | +852-39176955 | fleurlee@hku.hk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| School of Nursing, The University of Hong Kong | Recruiting | Hong Kong | 000000 | Hong Kong |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25859176 | Background | Lam TH, Cheung YT, Leung DY, Abdullah AS, Chan SS. Effectiveness of smoking reduction intervention for hardcore smokers. Tob Induc Dis. 2015 Apr 2;13(1):9. doi: 10.1186/s12971-015-0034-y. eCollection 2015. | |
| Background | Census and Statistics Department. Thematic Household Survey, Report No.59: Pattern of Smoking Hong Kong SAR: Hong Kong SAR Government. 2016. Available from: http://www.statistics.gov.hk/pub/B11302592016XXXXB0100.pdf. | ||
| 22175545 |
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|
| Health warning leaflet | Behavioral | At baseline, an A5-sized leaflet will be given to subjects, which includes information about risks of smoking, pictures of smoking-related diseases, and smoking cessation services provided in Hong Kong. |
|
| Active referral to smoking cessation (SC) services | Behavioral | At baseline, subjects will be encouraged to seek smoking cessation services in Hong Kong. If subjects agree, their contact information will be sent to the preferred service providers for a quick appointment and follow-up. |
|
| Regular messages through Instant Messaging (IM) | Behavioral | A total of pre-set 26 messages will be sent to subjects through WhatsApp 12 weeks after baseline to remind the quit date and to encourage abstinence. Messages are tailored based on subjects' sociodemographic characteristics and smoking habit following Social Cognitive Theory and Transtheoretical Model. Messages will be sent with the schedule of once daily for 1 week (the week across the quit date), 3 times a week for 4 weeks (2 weeks each before and after the week with quit date) and once a week for remaining 7 weeks. The schedule will be adjusted according to the quit date and also smokers' requests. The format of regular messages will mainly be text-based but also include pictures, animations and videos. |
|
| Psychosocial support and referral to SC services through IM | Behavioral | Personalized interactive text or voice conversation will be provided by trained smoking cessation advisors through WhatsApp for 3 months after baseline. Advisors will periodically proactively send messages to subjects to initiate the conversation (e.g. asking recent progress of smoking cessation) and deliver evidence-based advice. Advisors will also actively refer subjects, if they have expressed the need, to smoking cessation services providers. A standard operation algorithm for advisors used in the pilot feasibility trial will be modified for the use. |
|
| Message on general health delivered by short message service (SMS) | Behavioral | After baseline, regular messages using SMS will be sent to subjects with similar frequency to Intervention group. The messages include information on general health and reminders on follow-up surveys and biochemical validation for quitting. |
|
Self-reported no cigarette smoking (even a single puff) in the past 24 weeks
| 6-month and 12-month after baseline |
| Smoking reduction | Self-reported reduction in the number of cigarettes smoked daily by at least 50% of the baseline amount | 6-month and 12-month after baseline |
| Perceived importance, confidence and difficulties of quitting | Perceived importance, confidence and difficulties of quitting measured on a scale of 0-10 and a higher score indicates a stronger perception | 6-month and 12-month after baseline |
| Intention to quit | Any intention to quit smoking (yes/no) from baseline | 6-month and 12-month after baseline |
| Quit attempts | Number of quit attempts from baseline | 6-month and 12-month after baseline |
| Smoking cessation medication use | Any use of nicotine replacement therapy from baseline | 6-month and 12-month after baseline |
| Smocking cessation services use | Any use of counselling, hotline, SC clinics and other SC services from baseline | 6-month and 12-month after baseline |
| Background |
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| 38739429 | Derived | Wu YS, Cheung YTD, Lee JJJ, Wong CKH, Ho SY, Li WHC, Yao Y, Lam TH, Wang MP. Effect of Adding Personalized Instant Messaging Apps to a Brief Smoking Cessation Model in Community Smokers in Hong Kong: Pragmatic Randomized Clinical Trial. J Med Internet Res. 2024 May 13;26:e44973. doi: 10.2196/44973. |
| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D000067250 | Psychiatric Rehabilitation |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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