Effectiveness of a new multi-component smoking cessation service package for patients with hypertension and diabetes in northern Thailand: a randomized controlled trial (ESCAPE study)

Substance Abuse Treatment, Prevention, and Policy

Myo Nyein Aung¹  Payom Thinuan²  Thaworn Lorga²  Hirohide Yokokawa³  Hiroshi Fukuda³  Eiji Marui⁴  Yoshimune Hiratsuka⁵  Koichi Ono⁵  Susumu Tanimura⁶  Saiyud Moolphate⁷  Motoyuki Yuasa⁸  Tsutomu Kitajima⁹  Kazuo Minematsu^1,10  Yaoyanee Suya^1,11  Jitladda Deerojanawong^1,12 

[1] Advanced Health Science Institute, and Faculty of International Liberal Arts, Juntendo University;Boromrajonani College of Nursing;Department of General Medicine, Juntendo University School of Medicine;Department of Human Arts and Sciences, University of Human Arts and Sciences;Department of Opthalmology, Juntendo University School of Medicine;Department of Public Health Nursing, Mie University Graduate School of Medicine;Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University;Faculty of International Liberal Arts and Department of Public Health, School of Medicine, Juntendo University;Faculty of Social Science, Kyorin University;Graduate School of Education, Nagasaki University;Maetha Hospital;WHO Collaborating Center for Medical Education, Faculty of Medicine, Chulalogkorn University;

关键词: Tobacco;    Family;    Smokerlyzer;    Diary;    NRT;    Coaching;   

DOI  :  10.1186/s13011-019-0197-2

来源: DOAJ

【 摘 要 】

Abstract Background Smoking cessation is an achievable behavioral change, which reduces the risks of cardiovascular diseases, cancers and tobacco-related diseases. There is a need for an effective smoking cessation service for low and middle income country settings where the smoking rate is generally very high whilst a cessation service is not usually accessible. This study devised a new smoking cessation service package and assessed its effectiveness in the primary health care setting of northern Thailand. Methods This randomized controlled trial was centered at Maetha district hospital, Lampang province, Thailand, and its network of mobile non-communicable disease clinics at seven primary care units. A total of 319 eligible patients who consented to participate in the study, were randomly allocated to an intervention arm (160) and a control arm (159), applying block randomization. The multi-component intervention service consisted of:(1)regular patient motivation by the same nurse over a 3-month period;(2)a monthly piCO+ Smokerlyzer test for 3 months;(3)continual assistance from a trained family member, using a smoking-cessation- diary; and(4)optional nicotine replacement chewing gum therapy. The control group received the routine service comprising of brief counseling and casual follow-up. Smoking cessation, confirmed by six months of abstinence and the piCo+ Smokerlyzer breath test, was compared between the two services after a year follow-up. The trial is registered as an international current control trial at the ISRCTN registry. ISRCTN89315117. Results The median age of the participants was 64 years, with females constituting 28.84%. Most of the participants smoke hand-rolled cigarettes (85%). The intervention arm participants achieved a significantly higher smoking cessation rate than the control arm 25.62% vs 11.32%, with an adjusted odd ratio of 2.95 and 95% confidence interval 1.55–5.61. Conclusion In relation to accessing smoking cessation services within the primary health care setting, participants who received the evidence-based intervention package were about three times more likely to succeed in giving up smoking than those who received the routine service. Utilizing community resources as major intervention components, the evidence from this trial may provide a useful and scalable smoking cessation intervention for low and middle income countries. Trial registration Current controlled trials ISRCTN89315117. WHO international clinical trial identifier number: U1111–1145-6916; 3/2013.

【 授权许可】

Unknown