Effectiveness Of Counseling And Follow-up Booster In Smoking Cessation Clinic And Predictors Of Quitting Among Male Smokers

ObjectiveSmoking has become the main reason of Chinese male population morbidity andmortality, and the natural quit rate was low, effective smoking cessationinterventions are needed to be afforded to help smokers to quit. Hong Kong andwestern countries had a large number of studies reported the effect of differentinterventions for smoking cessation, but smoking cessation intervention in Chinawas scarce, only a few reported smoking cessation medication and psychologicalinterventions. To the best of our knowledge, no previous studies have investigatedwhether telephone follow-up booster after face-to-face counseling can increasequitting in China. In the present study, the hospital natural population was as acontrol group to evaluate the effect of face-to-face individual counseling aloneand face-to-face individual counseling plus telephone follow-up boostercounseling for Chinese male smokers, and its predictors of quitting.MethodThe face-to-face individual counseling alone group and face-to-face individualcounseling plus telephone follow-up booster counseling group were from smokerswho volunteered to seek treatment at our smoking cessation clinic in PLA generalhospital. At the first visit, trained physicians used a baseline questionnaire throughface-to-face interview and did body measurements, then provided individualface-to-face counseling lasted more than30minutes. Face-to-face individualcounseling alone group received1,3and6month follow-up each lasted3minutes,with only questions about smoking and quitting, but with no further intervention.We have collected149male smokers, and128(86%) completed6-monthfollow-up. Face-to-face individual counseling plus telephone follow-up booster counseling group received the same intervention at the first visit, but received1week,1,3and6month follow-up each lasted15-20minutes, we added a boosterand asked whether the smokers or quitters had any problems, providedproblem-oriented suggestions or advice as appropriate, and encouraged them toquit or maintain abstinence. We have collected398male smokers, and292(73%)completed6-month follow-up. Control group was from routine healthexamination center and internal medicine outpatient health smokers in PLAGeneral Hospital, the first visit and follow-up all not do any intervention. We havecollected164male smokers, and149(91%) completed6-month follow-up.ResultBy intention to treat, at6month follow-up, the7-day point prevalence quit rate ofcontrol group, face-to-face individual counseling alone group and face-to-faceindividual counseling plus telephone follow-up booster counseling group was7.9%,16.1%and25.9%, and3months continuous quit rate was6.7%,14.8%and19.3%, respectively. Stepwise logistic regression showed that face-to-faceindividual counseling plus telephone follow-up booster counseling, lowerFagerstr m score, perceived confidence in quitting and having doctor diagnosedtobacco-related chronic diseases were significant independent predictors of7-daypoint prevalence quitting at6-month follow-up. And Fagerstr m score and quitrates have a negative dose-response relationship, the lower the score the morelikely to quit.ConclusionTo the best of our knowledge, we have provided the first evidence from a smokingcessation clinic in China that regular telephone follow-up booster counseling canincrease the effectiveness of a face-to-face counseling alone. Our study has shownthat the quit rate of face-to-face counseling and face-to-face counseling plustelephone follow-up booster counseling are higher than control group, andface-to-face counseling plus telephone follow-up booster counseling is the bestone. The quit rates in our ‘real world’ observational study were much higher thansome western RCT studies. Lower Fagerstr m score, perceived confidence inquitting, at action stage of quitting, regular physical activity and having doctor diagnosed tobacco-related chronic diseases were significant predictors of quittingamong male smokers.