Smoking Cessation Program for the Older Smokers

A Randomized 2 by 2 Factorial Trial on mHealth Support and Financial Incentives to Promote Smoking Cessation in Deprived Older Smokers

This study aims to assess the effect of mobile health (mHealth) support or financial incentives and their interactive intervention effect on smoking cessation (SC) in old smokers in Hong Kong (HK).

Low-income older smokers are disproportionally harmed by tobacco use and the evidence of effectiveness of smoking cessation (SC) intervention for this deprived group is scarce. Leveraging evidence of effectiveness of mHealth support and financial incentives in other adults, the investigators propose a scalable mHealth and/or financial incentives model using age-friendly components for the deprived older smokers.

The 2x2 factorial design consists of 2 interventions, including (1) smartphone mHealth support by scheduled age-friendly multimedia e-messages and real-time personalized behavioral supports for 3 months, and (2) an escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.

The study aims to assess the effectiveness of two interventions and their interactive intervention effect.

Inclusion Criteria:

1. Smokers aged 60 years or above;
2. Currently smoking cigarettes or alternative tobacco products daily in the past 3 months with an exhaled carbon monoxide (CO) level ≥4ppm or salivary cotinine >30 ng/ml;
3. Have a mobile phone that can receive short message/messaging Service (SMS) or instant messages (IM);
4. Having a household monthly income lower than the median income of domestic household in Hong Kong

6. Hong Kong residents able to communicate in Chinese.

Exclusion Criteria:

1. Smokers not physically nor mentally fit for communication;
2. Smokers currently using SC services;
3. Hospitalized smokers;
4. Not having a mobile phone or perceived difficulty in using mobile phone or communication Apps