eHealth Record Sharing: enhancing participation for public health surveillance

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Motivating smokers at outdoor public smoking hotspots to have a quit attempt with a nicotine replacement therapy sample: study protocol for a randomized controlled trial

© 2016 Cheung et al.Background: About half of the daily smokers in Hong Kong have never tried and have no intention to quit smoking. More than one-third (37.9 %) of daily smokers have attempted to quit but failed. Nicotine replacement therapy (NRT) is a safe and effective pharmacotherapy to increase abstinence by reducing withdrawal symptoms during the early stage of smoking abstinence. However, the prevalence of NRT use in Hong Kong is lower than in most developed countries. The proposed study aims to assess the effectiveness of providing free NRT samples to smokers on increasing quit attempts and the quit rate. Methods: Trained university undergraduate students as ambassadors will invite smokers at outdoor public smoking hotspots to participate in the randomized controlled trial, in which eligible smokers will be randomized to receive a 1-week free NRT sample and medication counselling (intervention) or advice to purchase NRT on their own (control). The primary outcome is self-reported quit attempts (no smoking for at least 24 hours) in the past 30 days at 1-month and 3-month telephone follow-up. Discussion: The findings will inform the effectiveness of delivering free NRT samples at outdoor public smoking hotspots to increase quit attempts and abstinence. The study will also provide information on smokers' adherence to the NRT sample, side effects and safety issues related to the usage. This will improve the design of a large trial to test the effect of the NRT sample. Trial registration: ClinicalTrials.gov NCT02491086. Registered on 7 July 2015.published_or_final_versio

Effectiveness of smoking reduction intervention for hardcore smokers

© 2015 Lam et al.; licensee BioMed Central.Background: The prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons. Methods: A posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed. Results: In hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively. Conclusions: The a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.published_or_final_versio

Feasibility and effectiveness of a pilot outreach smoking cessation programme at smoking hotspots in Hong Kong

Parallel Session II: Prevention of Non-communicable DiseasesSince the enforcement of the smokefree legislation in 2007, more smokers have been gathering near some public rubbish bins at outdoor bus stops, outside office buildings and shopping malls to smoke. These “hotspots” provided an opportunity of publicizing and providing smoking cessation services to a large number of smokers and motivate them to quit. We aimed to promote smoking cessation at smoking hotspots and evaluate the feasibility and effectiveness of a pilot outreach approach. Out of the 26 smoking hotspots near shopping malls and commercial buildings, 10 hotspots with the great number of smokers were selected for the intervention from February to August 2009. Trained smoking cessation counsellors disseminated 2-page promotional leaflets and proactively delivered brief smoking cessation counselling (less than 5 minutes for each smoker) to smokers for 4 hours at each hotspot. We evaluated the programme by counting of smokers non-smokers 1 week before and 1 week after the intervention. We observed the smokers’ responses and behaviours when they were approached by the counsellors. In the observed 1,237 smokers at the 10 hotspots, the counsellors approached 751 (60.7%) smokers. 419 (55.8%) read or kept the promotional leaflets. 413 (55.0%) were willing to receive the brief on-site counselling. The intervention reduced the number of smokers at the hotspots by 7.8% (pre: 1,251, post: 1,154)) with 2.1% increase in non-smokers (pre: 5,004, post: 5,108). The proportion of smokers at hotspots reduced by 1.6% (95%CI 0.04%-3.1%, p=0.053) comparing 1 week before and after the intervention, whereas there was no significant difference in non-smokers (risk difference=1.6%, 95%CI -1.6%-4.7%, p=0.40). The outreach programme had a slightly positive impact to reduce the proportion of smokers at hotspots. The smoking hotpots are good locations for feasible and effective delivery of smoking cessation messages. Improvement in the approaching skills and incentives are needed.postprin

Secondhand smoke exposure and maternal action to protect children from secondhand smoke: Pre- and post-smokefree legislation in Hong Kong

Background: Smokefree legislation may protect children from secondhand smoke (SHS) in the home from smoking parent(s). We examined the effect of the 2007 smokefree legislation on children's exposure to SHS in the home and maternal action to protect children from SHS exposure in Hong Kong. Methods: Families with a smoking father and a non-smoking mother were recruited from public clinics before (2005-2006, n = 333) and after the legislation (2007-2008, n = 742) which led to a major extension of smokefree places in Hong Kong. Main outcomes included children's SHS exposure in the home, nicotine level in mothers' and children's hair and home environment, mothers' action to protect children from SHS, and their support to the fathers to quit. Results: Fewer mothers post-legislation reported children's SHS exposure in the home (87.2% versus 29.3%, p<0.01), which was consistent with their hair nicotine levels (0.36ng/mg versus 0.04ng/mg, p<0.01). More mothers post-legislation in the last month took their children away from cigarette smoke (6.3% versus 92.2%; p<0.01) and advised fathers to quit over 3 times (8.3% versus 33.8%; p<0.01). No significant change was found in the content of smoking cessation advice and the proportion of mothers who took specific action to support the fathers to quit. Conclusions: SHS exposure in the home decreased and maternal action to protect children from SHS increased after the 2007 smokefree legislation. Maternal support to fathers to quit showed moderate improvement. Cessation services for smokers and specific interventions for smoking families should be expanded together with smokefree legislation. © 2014 Chan et al.published_or_final_versio

Brief intervention to promote smoking cessation and improve glycemic control in smokers with type 2 diabetes: a randomized controlled trial

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Public support for electronic cigarette regulation in Hong Kong: A population-based cross-sectional study

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The effect of a very brief smoking-reduction intervention in smokers who have no intention to quit: Study protocol for a randomized controlled trial

BACKGROUND: Tobacco use is one of the most common preventable causes of death, but more than half of the Chinese men still use tobacco products. Moreover, 63.6% of Chinese smokers have stated that they would not consider quitting. Specialized and intensive smoking-cessation services are too expensive and passive to have major clinical and public health impacts in developing countries like China. Smoking cessation medications are not covered by medical insurance, and their high price prevents Chinese smokers from using them. Brief interventions are needed to provide cost-effective and timesaving tobacco dependence treatments in China mainland. METHODS/DESIGN: We describe a two-arm randomized controlled trial for smokers who have no intention to quit. The project will be conducted in outpatient clinics at a large hospital in Beijing, China. Both arms include one face-to-face interview plus five follow-up interventions. Each intervention will last approximately one minute. Subjects allocated to the smoking-reduction intervention arm (SRI) will be advised to reduce smoking consumption to at least half of their current consumption level within the next month. All subjects in the SRI will be warned to bear in mind that an attempt to reduce smoking is an intermediate step before complete cessation. Smokers who have successfully reduced their smoking consumption will be encouraged to completely cease smoking. Controls are subjects allocated to the exercise- and diet-advice arm (EDA) and will be given advice about healthy diet and physical activity, but the advice will not include smoking cessation or reduction. Data collection will be done at baseline and at each follow-up interview using standardized questionnaires. The primary outcomes include self-reported and biochemically verified 7-day point prevalence and prolonged abstinence rates at 12-month follow-up. DISCUSSION: We expect that an intention to quit in smoking outpatients can be motivated by physicians in the clinic setting. If this very brief smoking-reduction intervention can be demonstrated to have a positive impact on long-term smoking cessation, this strategy has the potential to be a viable and acceptable approach and may be used widely in China and elsewhere. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT02370147 (date of registration: 23th February, 2015).published_or_final_versio

Predictors of intention to quit at participation and six-month abstinence in the participants of Hong Kong Quit-to-Win Contest (2009-2013)

Poster Discussion 23. Cessation - Predictors and Policies: no. PD-864-20Conference Theme: Tobacco and Non-Communicable DiseasesBACKGROUND: Quit and Win Contests were organized in many countries to attract a large number of smokers, who mostly had not sought professional cessation support, to quit with the grand monetary prize as an incentive. The present study aims to explore the influential factors of being ready to quit (want to quit within 7 days) and abstinence in these participants. DESIGN/METHODS: The 4 rounds of Quit-to-Win Contests (2009, 2010, 2012 and 2013) recruited 4,093 adult daily …published_or_final_versio

Interventions to reduce suicides at suicide hotspots: a systematic review

Background: 'Suicide hotspots' include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention. Methods. We searched Medline for studies that could inform the following question: 'What interventions are available to reduce suicides at hotspots, and are they effective?'. Results: There are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise. Conclusions: More well-designed intervention studies are needed to strengthen this evidence base. © 2013 Cox et al.; licensee BioMed Central Ltd.published_or_final_versio