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Effectiveness of training stop‐smoking advisers to deliver cessation support to the UK national proposed standard versus usual care in Malaysia: a two‐arm cluster‐randomized controlled trial

Wee, Lei Hum and West, Robert and Tee, Guat Hiong and Yeap, Lena and Chan, Caryn Mei Hsien and Ho, Bee Kiau and Perialathan, Komathi and Nik Mohamed, Mohamad Haniki and Michie, Susan and Jackson, Sarah E. (2021) Effectiveness of training stop‐smoking advisers to deliver cessation support to the UK national proposed standard versus usual care in Malaysia: a two‐arm cluster‐randomized controlled trial. Addiction. E-ISSN 1360-0443 (In Press)

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Abstract

To assess the effectiveness of training stop smoking services providers in Malaysia to deliver support for smoking cessation based on the UK National Centre for Smoking Cessation and Training (NCSCT) standard treatment programme compared with usual care. Design Two‐arm cluster‐randomized controlled effectiveness trial across 19 sites with follow‐up at 4‐week, 3‐month, and 6‐month. Setting Stop smoking services operating in public hospitals in Malaysia. Participants Five hundred and two smokers [mean ± standard deviation (SD), age 45.6 (13.4) years; 97.4% male] attending stop smoking services in hospital settings in Malaysia: 330 in 10 hospitals in the intervention condition and 172 in nine hospitals in the control condition. Intervention and comparator The intervention consisted of training stop‐smoking practitioners to deliver support and follow‐up according to the NCSCT Standard Treatment Programme. The comparator was usual care (brief support and follow‐up). Measurements The primary outcome was continuous tobacco smoking abstinence up to 6 months in smokers who received smoking cessation treatment, verified by expired‐air carbon monoxide (CO) concentration. Secondary outcomes were continuous CO‐verified tobacco smoking abstinence up to 4 weeks and 3 months. Results Follow‐up rates at 4 weeks, 3 months and 6 months were 80.0, 70.6 and 53.3%, respectively, in the intervention group and 48.8, 30.8 and 23.3%, respectively, in the control group. At 6‐month follow‐up, 93 participants in the intervention group and 19 participants in the control group were abstinent from smoking, representing 28.2 versus 11.0% in an intention‐to‐treat (ITT) analysis assuming that participants with missing data had resumed smoking, and 52.8 versus 47.5% in a follow‐up‐only (FUO) analysis. Unadjusted odds ratios (accounting for clustering) were 5.04, (95% confidence interval (CI) = 1.22–20.77, P = 0.025) and 1.70, (95% CI = 0.25–11.53, P = 0.589) in the ITT and FUO analyses, respectively. Abstinence rates at 4 week and 3 month follow‐ups were significantly higher in the intervention versus control group in the ITT but not the FUO analysis. Conclusions On an intention‐to‐treat analysis with missing‐equals‐smoking imputation, training Malaysian stop smoking service providers in the UK National Centre for Smoking Cessation and Training standard treatment programme appeared to increase 6 month continuous abstinence rates in smokers seeking help with stopping compared with usual care. However, the effect may have been due to increasing follow‐up rates.

Item Type: Article (Journal)
Additional Information: 5123/87998
Uncontrolled Keywords: Effectiveness, Malaysia stop smoking services, randomized controlled trial, smoking cessation, stop smoking services, UK National Centre for Smoking Cessation and Training (UK NCSCT).
Subjects: R Medicine > RM Therapeutics. Pharmacology > RM147 Administration of Drugs and Other Therapeutic Agents
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Pharmacy > Department of Pharmacy Practice
Kulliyyah of Pharmacy
Depositing User: Assoc. Prof. Dr. Mohamad Haniki Nik Mohamed
Date Deposited: 25 Jan 2021 16:18
Last Modified: 25 Jan 2021 16:18
URI: http://irep.iium.edu.my/id/eprint/87998

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