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This pilot trial aims to examine the feasibility, acceptability, and preliminary effectiveness of EMA-based peer counseling for youth smokers.
Most smokers begin smoking during adolescence and early adulthood, a crucial period to prevent initiation and continuation of smoking. However, many proven smoking cessation interventions for adult smokers were not found effective in youth smokers, which may be partly explained by the vast differences in the pattern of tobacco use and determinants of quitting between adult and youth smokers. This calls for more research on novel intervention models to help young smokers quit.
The HKU Youth Quitline provides free smoking cessation support for smokers aged below 25 years since August 2005 in Hong Kong. The service provides multisession peer-led telephone counselling with an individualised quit plan devised for each young smoker according to their responses. Since the counselling model depends on the information retrospectively recalled by the smokers, it may be prone to recall and social desirability biases and fail to capture the variability of youth smoking patterns and momentary changes in personal (e.g., mood) and situational (e.g., peer smoking) antecedents of smoking episodes.
Recent advances in mobile technologies have enabled the use of more advanced and robust data collection approaches like ecological momentary assessment (EMA), which may benefit the counselling model by providing more ecologically valid data than traditional surveys. Previous studies have demonstrated the feasibility of using EMA to collect data on psychosocial processes and smoking behaviours in adolescent smokers. Therefore, we propose to develop and test a mobile EMA-based counselling intervention for youth smokers by conducting a pilot RCT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EMA+ group | Experimental | EMA assessment + EMA-based cessation counselling |
|
| EMA group | Active Comparator | EMA assessment only + Usual peer counselling |
|
| Control | Active Comparator | Usual peer counselling |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EMA assessment | Behavioral | Subjects will be asked to complete 3 waves of ecological momentary assessment (EMA) about smoking cues and smoking consumption via mobile phone at the first, second and third month after baseline (total 6 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Biochemically-validated tobacco abstinence | Defined as a negative result of the iScreen OFD test for measuring salivary cotinine (with a cut-off of lower than 30ng/mL) | 6 months after randomisation |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported 7-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 7 days | 3 months after randomisation |
| Self-reported 7-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Recruitment rate | Proportion of participants among all eligible subjects | Through recruitment completion, about 6 months |
| Retention rate | Proportion of participants responding to telephone follow-up |
Inclusion Criteria:
Exclusion Criteria:
Youth smokers who are participating in other smoking cessation studies or program other than the HKU Youth Quitline
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| Name | Affiliation | Role |
|---|---|---|
| Tzu Tsun Luk, PhD, RN | The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| HKU Youth Quitline | Hong Kong | Hong Kong |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18566161 | Background | Chan SS, Wong DC, Fong DY, Leung AY, Lam DO, Mak YW, Lam TH. The establishment and promotion of the first Youth Quitline in Hong Kong: challenges and opportunities. Eval Health Prof. 2008 Sep;31(3):258-71. doi: 10.1177/0163278708320156. Epub 2008 Jun 19. | |
| 18509902 | Background | Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1-32. doi: 10.1146/annurev.clinpsy.3.022806.091415. |
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| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
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| EMA-based cessation counselling | Behavioral | Subjects will receive tailored peer counselling based on the participants' EMA responses at 1-month and 3-month telephone follow-ups. |
|
| Usual peer counselling | Behavioral | Subjects will receive peer counselling through telephone during follow-ups (usual care), in which the counsellor will apply the 5As model and motivational interviewing techniques. |
|
| 6 months after randomisation |
| Self-reported 30-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 30 days | 3 months after randomisation |
| Self-reported 30-day point-prevalence tobacco abstinence | Being completely smoke-free in the past 30 days | 6 months after randomisation |
| Smoking reduction by at least 50% | Smoking reduction by at least half of the baseline daily number of cigarettes | 3 months after randomisation |
| Smoking reduction by at least 50% | Smoking reduction by at least half of the baseline daily number of cigarettes | 6 months after randomisation |
| 6 months after randomisation |
| 21942749 | Background | Van Zundert RM, Ferguson SG, Shiffman S, Engels R. Dynamic effects of craving and negative affect on adolescent smoking relapse. Health Psychol. 2012 Mar;31(2):226-34. doi: 10.1037/a0025204. Epub 2011 Sep 26. |
| 29737885 | Background | McClure EA, Tomko RL, Carpenter MJ, Treiber FA, Gray KM. Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers. Am J Drug Alcohol Abuse. 2018;44(5):561-570. doi: 10.1080/00952990.2018.1467431. Epub 2018 May 8. |
| 29148565 | Background | Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone-Banks J, Hartmann-Boyce J. Tobacco cessation interventions for young people. Cochrane Database Syst Rev. 2017 Nov 17;11(11):CD003289. doi: 10.1002/14651858.CD003289.pub6. |