Personalized chat-based support for smoking cessation among smokers with mental health symptoms in the workplace: A randomized controlled trial

IF 5.3 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2025-02-09 DOI:10.1111/add.70013

Ying Yao, Tzu Tsun Luk, Oi Sze Lau, Yongda Socrates Wu, Xue Weng, Chak Hang Ng, Yee Tak Derek Cheung, Tai Hing Lam, Man Ping Wang

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Abstract

Aims

Smoking rates are disproportionately high among people with mental health issues. We evaluated the effectiveness of a chat-based intervention paired with psychological support for workplace smokers with mental health symptoms.

Design and setting

A pragmatic, two-arm, randomized controlled trial in 65 companies in Hong Kong, China.

Participants

300 employees who smoked daily (84.3% male) with stress (Perceived Stress Scale-4 ≥ 6), anxiety (General Anxiety Disorder-2 ≥ 3) or depressive symptoms (Patient Health Questionnaire-2 ≥ 3).

Interventions

Participants were randomly allocated to either the intervention group (n = 144) or the control group (n = 156). The intervention group received 20 instant messages and chat-based support delivered by trained counselors over 3 months, using Acceptance and Commitment Therapy. The control group received 6 messages on general health. Both groups received a health talk and self-help booklet at baseline, brief phone advice at follow-ups and full-course nicotine replacement therapy for continuing smokers at 6 months.

Measurements

The primary outcome was self-reported 7-day point prevalence abstinence (PPA) at 6 months after intervention initiation. Secondary outcomes included PPA at 1, 3, 9 and 12 months, changes in mental health symptoms and intervention engagement (chatting with counsellors).

Findings

By intention to treat, there was no evidence of a difference in 7-day PPA between intervention and control group at 6 months [16.0% vs. 13.5%, odds ratio (OR) = 1.22, 95% confidence interval (CI) = 0.64–2.32]. At 12 months, there was weak evidence of an intervention benefit (21.5% vs. 13.5%, 1.76, 0.96–3.24), which was statistically significant after adjusting for baseline factors (adjusted OR = 2.61, 1.22–5.58, P = 0.01). A greater reduction in anxiety symptoms over a 12-month period in the intervention group was observed (adjusted b = −0.28, 95% CI = −0.56 to −0.00, P = 0.05).

Conclusions

There appears to be weak evidence for a benefit of a personalised chat-based smoking cessation intervention plus psychological support on promoting smoking abstinence among workplace smokers with mental health symptoms.

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工作场所有心理健康症状的吸烟者戒烟的个性化聊天支持：一项随机对照试验

目的：在有心理健康问题的人群中，吸烟率高得不成比例。我们评估了以聊天为基础的干预与心理支持相结合对有心理健康症状的工作场所吸烟者的有效性。设计与环境：一项在中国香港65家公司进行的务实、双组、随机对照试验。参与者：300名有压力（感知压力量表-4≥6）、焦虑（一般焦虑障碍-2≥3）或抑郁症状（患者健康问卷-2≥3）、每日吸烟的员工（男性84.3%）。干预：参与者被随机分配到干预组（n = 144）和对照组（n = 156）。干预组接受了20条即时消息和聊天支持，由训练有素的咨询师在3个月内提供，使用接受和承诺疗法。对照组收到6条关于一般健康的信息。两组在基线时都接受了健康讲座和自助手册，在随访时接受了简短的电话咨询，在六个月时对持续吸烟者进行了全程尼古丁替代治疗。测量：主要结果是干预开始后6个月自我报告的7天点流行戒断（PPA）。次要结果包括1、3、9和12个月时的PPA、心理健康症状的变化和干预参与（与咨询师聊天）。结果：在意向治疗方面，干预组与对照组在6个月时7天PPA无差异[16.0% vs. 13.5%，优势比(OR) = 1.22, 95%可信区间(CI) = 0.64-2.32]。在12个月时，干预获益的证据较弱（21.5% vs. 13.5%, 1.76, 0.96-3.24），在调整基线因素后具有统计学意义（调整OR = 2.61, 1.22-5.58, P = 0.01）。在12个月的时间里，观察到干预组的焦虑症状有更大的减轻（调整后的b = -0.28, 95% CI = -0.56至-0.00,P = 0.05）。结论：在有心理健康症状的工作场所吸烟者中，个性化的聊天戒烟干预和心理支持对促进戒烟的益处似乎没有充分的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.