Effectiveness of Personalized Cardiovascular Risk Score on Employee Smoking Behavior: An RCT

Abstract

Abstract Background Based on the Nudge Theory, an individual could make better decisions by offering small changes to the choices offered that could lead to dramatic changes in their behaviors. A cardiovascular risk score could be added to the employee health checkup report and become a good nudge for smoking employees. This study aimed to compare the effect of various personalized cardiovascular risk score reports on employee smoking cessation. Methods This three-arm randomized controlled trial recruited smoking employees of a 600-bed hospital in Bangkok, Thailand, and was conducted during January-April, 2020. The cardiovascular risk score of each participant was calculated by using the 2013 American College of Cardiology and American Heart Association guidelines. While a conventional annual checkup report was provided to all participants, intervention group A also received both smoking-positive and smoking-negative risk scores whereas intervention group B also received a smoking-positive risk score. The number of cigarettes was collected at weeks 0, 4, 8, and 12. The changes in the number of cigarettes were analyzed by using repeated measure ANOVA. Results Thirty-six smoking employees were recruited (mean age 35.67±10.54 years; male 97.2%). Two-third (66.7%) had a low cardiovascular risk. The participants smoked 53.03±47.88 cigarettes per week and 66.7% did not have the intention to quit smoking. For Group A, the number of cigarettes significantly reduced by 19.58 (p = 0.04), 28.92 (p = 0.00), and 35.50 (p = 0.00) at weeks 4, 8, and 12, respectively. For Group B, the number of cigarettes reduced by 14.25 (p = 0.13), 21.35 (p = 0.03), and 18.08 (p = 0.06) at weeks 4, 8, and 12, respectively. For Group C, the number of cigarettes increased by 0.42 (p = 0.96), 5.89 (p = 0.54), and 12.44 (p = 0.20) at weeks 4, 8, and 12, respectively. Conclusions Cardiovascular risk score in an employee checkup report could be a simple yet effective intervention for smoking cessation. Key messages Based on the Nudge Theory, an individual could make healthier decisions by offering small changes to the choices offered that could lead to a reduction in cigarette consumption. Cardiovascular risk score in an employee checkup report could be a simple yet effective intervention for smoking cessation.