Guo Ningyuan, Luk Tzu Tsun, Wu Yongda Socrates, Guo Ziqiu, Chu Jessica Chi Lok, Cheung Yee Tak Derek, Chan Ching Han Helen, Kwok Tyrone Tai On, Wong Victor Yiu Lun, Wong Carlos King Ho, Lee Jung Jae, Kwok Yu Kwong, Viswanath Kasisomayajula, Lam Tai Hing, Wang Man Ping
School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
School of Nursing, The University of Hong Kong, Hong Kong, China.
Tob Induc Dis. 2023 Mar 24;21:44. doi: 10.18332/tid/160168. eCollection 2023.
Mobile interventions enable personalized behavioral support that could improve smoking cessation (SC) in smokers ready to quit. Scalable interventions, including unmotivated smokers, are needed. We evaluated the effect of personalized behavioral support through mobile interventions plus nicotine replacement therapy sampling (NRT-S) on SC in Hong Kong community smokers.
A total of 664 adult daily cigarette smokers (74.4% male, 51.7% not ready to quit in 30 days) were proactively recruited from smoking hotspots and individually randomized (1:1) to the intervention and control groups (each, n=332). Both groups received brief advice and active referral to SC services. The intervention group received 1-week NRT-S at baseline and 12-week personalized behavioral support through SC advisor-delivered Instant Messaging (IM) and a fully automated chatbot. The control group received regular text messages regarding general health at a similar frequency. Primary outcomes were carbon monoxide-validated smoking abstinence at 6 and 12 months post-treatment initiation. Secondary outcomes included self-reported 7-day point-prevalence and 24-week continuous abstinence, quit attempts, smoking reduction, and SC service use at 6 and 12 months.
By intention-to-treat, the intervention group did not significantly increase validated abstinence at 6 months (3.9% vs 3.0%, OR=1.31; 95% CI: 0.57-3.04) and 12 months (5.4% vs 4.5%, OR=1.21; 95% CI: 0.60-2.45), as were self-reported 7-day point-prevalence abstinence, smoking reduction, and SC service use at 6 and 12 months. More participants in the intervention than control group made a quit attempt by 6 months (47.0% vs 38.0%, OR=1.45; 95% CI: 1.06-1.97). Intervention engagement rates were low, but engagement in IM alone or combined with chatbot showed higher abstinence at 6 months (adjusted odds ratios, AORs=4.71 and 8.95, both p<0.05).
Personalized behavioral support through mobile interventions plus NRT-S did not significantly improve abstinence in community smokers compared to text only messaging. The suboptimal intervention engagement needs to be addressed in future studies.
ClinicalTrials.gov NCT04001972.
移动干预能够提供个性化行为支持，这可能会提高有戒烟意愿的吸烟者的戒烟成功率。需要可扩展的干预措施，包括针对无戒烟意愿的吸烟者。我们评估了通过移动干预加尼古丁替代疗法抽样（NRT-S）提供的个性化行为支持对香港社区吸烟者戒烟的影响。
从吸烟热点地区主动招募了664名成年每日吸烟者（74.4%为男性，51.7%在30天内无戒烟意愿），并将其个体随机分为干预组和对照组（每组n = 332）。两组均接受简短建议并被积极转介至戒烟服务。干预组在基线时接受为期1周的NRT-S，并通过戒烟顾问提供的即时通讯（IM）和全自动聊天机器人接受为期12周的个性化行为支持。对照组以类似频率接收有关一般健康的常规短信。主要结局为治疗开始后6个月和12个月经一氧化碳验证的戒烟情况。次要结局包括自我报告的7天点患病率和24周持续戒烟情况、戒烟尝试、吸烟减少情况以及6个月和12个月时的戒烟服务使用情况。
按意向性分析，干预组在6个月（3.9%对3.0%，OR = 1.31；95%CI：0.57 - 3.04）和12个月（5.4%对4.5%，OR = 1.21；95%CI：0.60 - 2.45）时经验证的戒烟率未显著提高，6个月和12个月时自我报告的7天点患病率戒烟、吸烟减少情况以及戒烟服务使用情况也是如此。干预组在6个月时进行戒烟尝试的参与者比对照组更多（47.0%对38.0%，OR = 1.45；95%CI：1.06 - 1.97）。干预参与率较低，但仅参与IM或与聊天机器人结合参与的参与者在6个月时戒烟率更高（调整后的优势比，AORs = 4.71和8.95，均p < 0.05）。
与仅发送短信相比，通过移动干预加NRT-S提供的个性化行为支持并未显著提高社区吸烟者的戒烟率。未来研究需要解决干预参与度欠佳的问题。
ClinicalTrials.gov NCT04001972。
