Abstract
AimsTo 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.DesignTwo‐arm cluster‐randomized controlled effectiveness trial across 19 sites with follow‐up at 4‐week, 3‐month, and 6‐month.SettingStop smoking services operating in public hospitals in Malaysia.ParticipantsFive 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 comparatorThe 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).MeasurementsThe 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.ResultsFollow‐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.ConclusionsOn 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.
Highlights
Stop smoking services that provide a combination of behavioural and pharmacological support have been shown to be effective in increasing success rates in smokers trying to stop smoking [1,2], but few randomized controlled trials have been undertaken outside high-income countries
This paper reports a trial assessing whether training based on this model, delivered to stop smoking practitioners in Malaysia, a country with a different culture and tobacco control climate, would increase success rates of stop smoking services
The primary research question (RQ) was: 1 What is the effectiveness of training stop-smoking practitioners to provide an adapted version of the UK National Centre for Smoking Cessation and Training (NCSCT) standard treatment programme compared with usual care in achieving an increase in the percentage achieving 6-month continuous tobacco smoking abstinence in smokers who attend stop smoking services in Malaysia? Secondary RQs were: 1 In the same population, setting and intervention versus comparator for RQ1, what is the effect in achieving an increase in the percentage achieving 4-week continuous tobacco smoking abstinence?
Summary
Stop smoking services that provide a combination of behavioural and pharmacological support have been shown to be effective in increasing success rates in smokers trying to stop smoking [1,2], but few randomized controlled trials have been undertaken outside high-income countries. Ncsct.co.uk) to (i) identify the competences required to deliver, manage and commission smoking cessation support; (ii) develop and implement methods of assessment of these competences; and (iii) commission and provide training and continuing support to allow staff to achieve the required level of competence. This led to development of the NCSCT standard treatment programme and evidence-based training [4] (for details see ‘Intervention’ section). This paper reports a trial assessing whether training based on this model, delivered to stop smoking practitioners in Malaysia, a country with a different culture and tobacco control climate, would increase success rates of stop smoking services
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
