Abstract
Rationale
There are over 300 million Chinese smokers, but use of nicotine replacement therapy (NRT) is rare. On the other hand, data on the factors associated with quitting and adherence to NRT use are scarce in the East.
Objectives
To describe adherence and other predictors of quitting smoking at the 12-month follow-up amongst Chinese smokers in Hong Kong.
Methods
Chinese smokers (1186) who attended the Smoking Cessation Health Centre from August 2000 through January 2002 were studied. Trained counsellors provided individual counselling and carried out follow-up interviews. We used structured questionnaires at baseline and at 1, 3 and 12 months and an intention-to-treat approach for analysis.
Results
Among those who received NRT (1051/1186), the prevalence of adherence (self-reported NRT use for at least 4 weeks) was 16% (95% confidence interval 14–18%). The 7-day point prevalence quit rate at 12 months (not smoking any cigarette during the past 7 days at the 12 month follow-up) was 27% (95% CI, CI 24–29%). Stepwise logistic regression model showed that adherence to NRT use, a higher income, good perceived health and having more confidence in quitting were significant predictors of quitting. The quit rate in the adherent group (40%) was greater than that of the non-adherent group (25%) (P<0.001). Older age, male, higher education, experience of NRT use, perceiving quitting as more difficult and willingness to pay were significant predictors of adherence.
Conclusions
Clinically significant smoking cessation rates can be achieved among Chinese smokers in a clinic-based smoking cessation service. The NRT adherence was low and low adherence was associated with a lower quit rate. Trials of interventions to improve adherence and increase quit rates are needed.
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Acknowledgements
We thank Pharmacia Upjohn and Novartis for partially sponsoring the printing cost of the clinic pamphlets and providing some free NRT samples. The study was sponsored by the Hong Kong Council on Smoking and Health.
Conflicts of interest: T.H. Lam is vice chair of Hong Kong Council on Smoking and Health (COSH), A.J. Hedley was former chair of COSH and ASM Abdullah is the Director of the Hong Kong Smoking Cessation Health Centre. Smoking cessation services was supported in part by concessionary rates on NRT products.
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Professor A.J. Hedley (Chair Professor, Department of Community Medicine, The University of Hong Kong; Former Chairman, Hong Kong Council on Smoking and Health, COSH), Professor T.H. Lam (Head, Department of Community Medicine, The University of Hong Kong; Vice Chairman, COSH), Dr. A.S. M Abdullah, (Director, Hong Kong Smoking Cessation Health Centre; Research Assistant Professor, Department of Community Medicine, The University of Hong Kong), Dr. S.C. Chan (Head, Department of Nursing Studies, The University of Hong Kong), Mr. Marcus Yu and Dr. Raymond LM Ho (Former and current Executive Director, COSH), Dr. W.L. Lo (Council Member, COSH), Mr. Alfred Chan (Former Senior Project Manager, COSH), Professor Edith Lau, (Professor, Department of Community and Family Medicine, Chinese University of Hong Kong; Council Member, COSH), Dr. J.L. Tang (Associate Professor, Department of Community and Family Medicine, Chinese University of Hong Kong), Dr. S.Y. Chan (Associate Professor, Department of Community and Family Medicine, Chinese University of Hong Kong), Dr. H.C. Ma (Chief Executive, Ruttonjee Hospital), Dr. C.W. Lam (Head of Respiratory Medicine, Ruttonjee Hospital), Dr. Y.K. Lau (Head of Cardiology Division, Ruttonjee Hospital).
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Lam, TH., Abdullah, A.S.M., Chan, S.S.C. et al. Adherence to nicotine replacement therapy versus quitting smoking among Chinese smokers: a preliminary investigation. Psychopharmacology 177, 400–408 (2005). https://doi.org/10.1007/s00213-004-1971-y
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DOI: https://doi.org/10.1007/s00213-004-1971-y