Abstract
BackgroundDifferent smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting.MethodsThe Mobile Smoking Cessation Programme (MSCP) targeted elderly smokers (aged 60 or above) and provided service in a place that was convenient to the elderly. Trained counsellors provided individual counselling and 4 week's free supply of nicotine replacement therapy (NRT). Follow up was arranged at 1 month by face-to-face and at 3 and 6 months by telephone plus urinary cotinine validation. A structured record sheet was used for data collection. The service was evaluated in terms of process, outcome and cost.Results102 governmental and non-governmental social service units and private residential homes for the elderly participated in the MSCP. We held 90 health talks with 3266 elderly (1140 smokers and 2126 non-smokers) attended. Of the 1140 smokers, 365 (32%) received intensive smoking cessation service. By intention-to-treat, the validated 7 day point prevalence quit rate was 20.3% (95% confidence interval: 16.2%–24.8%). Smoking less than 11 cigarettes per day and being adherent to NRT for 4 weeks or more were significant predictors of quitting. The average cost per contact was US$54 (smokers only); per smoker with counselling: US$168; per self-reported quitter: US$594; and per cotinine validated quitter: US$827.ConclusionThis mobile smoking cessation programme was acceptable to elderly Chinese smokers, with quit rate comparable to other comprehensive programmes in the West. A mobile clinic is a promising model to reach the elderly and probably other hard to reach smokers.
Highlights
Different smoking cessation programmes have been developed in the last decade but utilization by the elderly is low
We examined the effectiveness of a mobile smoking cessation service in reaching elderly Chinese smokers in Hong Kong and identified predictors of quitting
We aimed to answer four specific questions: (1) Would Chinese elderly smokers participate in a mobile smoking cessation programme (MSCP)? (2) Is the programme effective in promoting smoking cessation among elderly Chinese smokers? (3) What are the predictors of quitting among the Chinese elderly? (4) What are the costs of the programme?
Summary
Different smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting. The prevalence of cigarette smoking was 14% in Hong Kong people aged over 60 in the 1998 General Household Survey and there were a total of 129,600 older smokers at that time [8]. In Hong Kong, there has been a lack of smoking cessation services and there is no evidence whether such services could help older people to quit smoking. About 15% of smokers aged 60 and older wanted to quit within the 6 months [10] and evidence elsewhere shows that older smokers are more likely to be successful in quitting attempts than smokers aged 35–64.[11] This paper reports the acceptance and benefits of smoking cessation services among older smokers in Hong Kong
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