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A randomized controlled trial of stage-matched intervention for smoking cessation in cardiac out-patients
Sophia S C Chan1, Doris Y P Leung, David C N Wong
1School of Nursing, The University of Hong Kong, LKS Faculty of Medicine, Pokfulam, Hong Kong. nssophia@hkucc.hku.hk
Insights
A stage-matched smoking cessation intervention for Chinese cardiac patients did not significantly improve long-term tobacco abstinence rates. This study found no significant difference in smoking cessation between the intervention and control groups at 12 months.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Smoking is a major risk factor for cardiac diseases.
- Cardiac patients often struggle with smoking cessation.
- Tailored interventions may improve cessation rates in this population.
Purpose of the Study:
- To evaluate the effectiveness of a stage-matched smoking cessation counselling intervention.
- To assess the intervention's impact on cardiac patients in China.
Main Methods:
- 1860 Chinese cardiac smokers were randomized into intervention or control groups.
- Intervention group received stage-matched counselling; control group received brief diet advice.
- Primary outcomes were self-reported 7-day and 30-day point prevalence abstinence at 12 months.
Main Results:
- No significant difference in self-reported 7-day (26.5% vs 25.5%) or 30-day (25.4% vs 24.2%) point prevalence abstinence at 12 months.
- Biochemically validated abstinence also showed no significant difference (6.6% vs 4.9%).
- The intervention group had more quit attempts of at least 24 hours (40.3% vs 34.3%; P=0.007).
Conclusions:
- A stage-matched smoking cessation intervention based on the Stages of Change model did not yield long-term benefits for Chinese cardiac patients.
- Further research may be needed to identify effective cessation strategies for this demographic.
Aim:
To examine the effectiveness of a stage-matched smoking cessation counselling intervention for smokers who had cardiac diseases.
Methods:
A total of 1860 Chinese cardiac patients who smoked at least one cigarette in the past 7 days and aged 18 years or above recruited from cardiac out-patient clinics in Hong Kong hospitals were allocated randomly to an intervention group or control group. The intervention group (n = 938) received counselling matched with their stage of readiness to quit by trained counsellors at baseline, 1 week and 1 month. The control group (n = 922) received brief counselling on healthy diet at baseline. The primary outcomes were self-reported 7-day and 30-day point prevalence (PP) of tobacco abstinence at 12 months after baseline. The secondary outcome measures included biochemically validated abstinence at 12-month follow-up, self-reported 7-day and 30-day PP abstinence and reduction of cigarette consumption by 50% at 3 and 6 months.
Results:
By intention-to-treat analysis, the intervention and control groups showed no significant difference in self-reported 7-day PP abstinence (intervention: 26.5% versus control: 25.5%; P = 0.60) and 30-day PP (intervention: 25.4% versus control: 24.2%; P = 0.55), biochemically validated abstinence (intervention: 6.6% versus control: 4.9%; P = 0.14) and overall quit attempts of least 24 hours (intervention: 40.3% versus control: 34.3%; P = 0.007) at the 12-month follow-up, adjusted for the baseline stage of readiness to quit smoking.
Conclusions:
An intervention, based on the Stages of Change model, to promote smoking cessation in cardiac patients in China failed to find any long-term benefit.
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