October 24, 2017
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Combined brief intervention effective for smoking cessation

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An intervention that combines brief smoking cessation advice with active referral to smoking cessation services was more effective among smokers at 6 months than only brief general advice, according to data published in JAMA Internal Medicine.

Smoking cessation services providing evidence-based interventions improve quitting substantially, but only 16% of smokers ever use [smoking cessation] services worldwide. Low-cost and effective methods are needed to increase the use of [smoking cessation] clinics or quitlines and thus quit rates,” Man Ping Wang, PhD, University of Hong Kong, and colleagues wrote.

Between June 20, 2015, and Sept. 24, 2015, Wang and colleagues performed a single-blind, pragmatic cluster randomized clinical trial to compare the effectiveness of three interventions for smoking cessation among community smokers: brief smoking cessation advice plus active referral to smoking cessation services (active referral group), brief smoking cessation advice only (brief advice group) and general smoking advice only (control group).

The researchers recruited 1,226 adult daily smokers (80.8% men; mean age, 42 years) from the 2015 Quit-to-Win Contest who lived in the general Hong Kong community. They randomized participants into either the active referral (n = 402), brief advice (n = 416) or control (n = 408) group.

Participants in the active referral group received advice from smoking cessation ambassadors who used the AWARD (ask about history of smoking, warn about smoking risks, advise to quit, refer smokers to smoking cessation services and do it again) model. Participants in the brief advice group also received AWARD-guided advice, but were only encouraged to visit a smoking cessation service professional rather than actively referred to one.

At 1 and 2 months, participants in both the active referral and brief advice groups were offered brief counseling over the telephone. At 3 and 68 months, the response rate was 68.2% and 72.3%, respectively.

The active referral group had higher self-reported past 7-day point prevalence of abstinence (18.9% at 3 months and 17.2% at 6 months) than the brief advice (8.9% and 9.4%) and control (14% and 11.5%) groups. Participants in the active referral group had significantly higher validated abstinence rates in the at 3 (10.2%) and 6 (9.0%) months, in comparison to those in the brief advice (3.8% and 5%) and control (4.2% and 5.1%) groups.

Additionally, the active referral group had a significantly higher smoking cessation service use rate (25.1%) at 6 months, compared with the brief advice (2.4%) and control (3.4%) group.

“A combined brief intervention of smoking cessation advice and active referral can be used in community settings to recruit smokers and help them to quit,” Wang and colleagues concluded. – by Alaina Tedesco

Disclosure: Wang and colleagues report no relevant financial disclosures.