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Smoking CessationQTW2020NCT04399967

COVID-19 Brief Advice and Chat-based Support for Smoking Cessation Via "Quit to Win" Contest 2020

A study testing Chat-based support, AWARD plus COVID-specific advice and AWARD advice in people with Smoking Cessation, run by The University of Hong Kong at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The present study will examine (1) the effectiveness of a combined brief advice and personalized chat-based support on COVID-19 related smoking messages and (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Smoking Cessation
What is being tested?
Chat-based support, AWARD plus COVID-specific advice and AWARD advice
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,166 participants
Where
1 siteChina
Study dates
13 Jun 2020to 30 Jun 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Hong Kong residents aged 18 or above
  • Smoke at least 1 tobacco stick per day or use e-cigarette daily in the past 3-month
  • Able to communicate in Cantonese (including reading Chinese)
  • Saliva cotinine 30 ng/ml or above
  • Intent to quit / reduce smoking
  • Able to use instant messaging tool (e.g., WhatsApp, WeChat) for communication.

Who cannot join

  • Smokers who have communication barrier (either physically or cognitively)
  • Smokers who are currently participating in other SC programmes or services

Trial locations and contacts

1 site in 1 country.

China1 site

  • Hong Kong Council on Smoking and Health (COSH)

    Hong Kong, Hong Kong, 852

Other trials in China

About this study

Official title: Building Capacity and Promoting Smoking Cessation in the Community Via "Quit to Win" Contest 2020: a Single-blind Randomized Controlled Trial on COVID-19 Related Brief Advice and Personalized Chat-based Intervention for Smoking Cessation

The present study will examine (1) the effectiveness of a combined brief advice and personalized chat-based support on COVID-19 related smoking messages and (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, a process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.

Read the detailed description

Smoking is detrimental to the immune system and can cause respiratory tract infection. Growing evidence has suggested that compared to non-smokers, COVID-19 patients who have a history of smoking are at a higher risk of developing severe respiratory and cardiovascular symptoms, consequently may require mechanical ventilation and intensive care. A case series of 1,099 COVID-19 patients in China has found that ever smokers, compared with never smokers, were more likely to have severe COVID-19 disease upon hospital admission and be admitted to intensive care unit, need to use mechanical ventilation, and die. The result is corroborated by a multivariable analysis of 78 COVID-19 pneumonia cases in China, which identified smoking as the only preventable risk factor for disease progression. While the link between smoking and the COVID-19 needs further research, smokers appear to be at a greater risk of suffering from serious symptoms due to COVID-19.

The practice of smoking might also predispose smokers to COVID-19 infection. Smoking behavior is characterized by inhalation and the hand-to-mouth movements which increase the possibility of transmission of virus from contaminated fingers and cigarettes to mouth. In Hong Kong, where smoking is banned in indoor public areas and workplace, smokers often gather and smoke at smoking hotspots outdoor, where ashtrays are available. This increases their risk of infection since the smokers are in close contact with each other and have to remove their mask to smoke. Exhaling smoke also aids the spreading the virus in the air. However, misleading information that smoking can prevent COVID-19 infection is widespread on social media.

Public health strategies (e.g., social distancing, staying at home and working from home) may motivate some smokers to reduce or to quit smoking due to the inconvenience to smoke indoor and to buy cigarettes from retail outlets. However, home confinement may result in social isolation and psychological distress (anxiety and stress) both increasing the need for smoking. Some smokers who are not used to smoke at home might be prompted to smoke at home to cope with their craving during lockdown or work from home, which may also expose their family members from second-hand smoke.

Our RCT in QTW Contest 2017 evaluated the effectiveness of a chat-based intervention delivered through a mobile instant messaging application (WhatsApp) plus active referral to SC services to increase quitting. Chat-based intervention resulted in higher abstinence rate compared with the control group at 6-month follow-up. In QTW Contest 2019, we evaluated the effectiveness of a combined intervention of AWARD advice, active referral, instant messaging and optional cocktail intervention to increase abstinence. The preliminary result showed that the personalized instant messaging (PIM) group and regular instant messaging (RIM) group had similar abstinence rate at 6-month follow-up.

Therefore, the present study will examine (1) the effectiveness of a combined brief advice and personalized chat-based support on COVID-19 related smoking messages and (2) explore the use of CBPR model to build capacity and to engage community partners in taking on this important public health issue for sustainability in the community. In addition, a process evaluation will be conducted to assess the effectiveness of the recruitment activity and how it is linked with the overall program outcomes.

Being tested
Chat-based support, AWARD plus COVID-specific advice, AWARD advice, COVID-19 related health warning leaflet, Health warning leaflet
Keywords
Smoking cessation, Quit to Win, COVID-19
Medical subject headings
Smoking Cessation, COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Chat-based supportBehavioural

    Participants will receive three months of chat-based support through IM apps (e.g. WhatsApp, WeChat). The regular messages and instant messaging on psychosocial support aim to provide hygienic advice to reduce the risk of exposure to SARS-cov2, increase self-efficacy and confidence, and social support and behavioral capacity of quitting.

  • AWARD plus COVID-specific adviceBehavioural

    Also called Ask, Warn, Advise, Refer, Do-it-again

    Ask about smoking history, Warn about the risks associated with the COVID-19 and smoking (with a COVID-related health warning leaflet), Advise to quit as soon as possible during the COVID-19 pandemic, Refer smokers to SC services (with a referral card, see below for information), and Do it again: to repeat the intervention

  • AWARD adviceBehavioural

    Also called Ask, Warn, Advise, Refer, Do-it-again

    Ask about smoking history, Warn about the high risk of smoking, Advise to quit as soon as possible, Refer to the smoking cessation services, and Do it again (if the smokers refused to set quit date).

  • COVID-19 related health warning leafletBehavioural

    The 2-sided color printed A4 leaflet, which covers the risk of COVID-19 and smoking and the most important messages to motivate smoking cessation

  • Health warning leafletBehavioural

    Also called Brief leaflet on health warning and smoking cessation

    The 2-sided color printed A4 leaflet, which systematically covers the most important messages to motivate smoking cessation.

  • SMS-based supportBehavioural

    Participants will receive regular SMS with similar frequency to Intervention group but with generic information on smoking cessation.

  • Referral cardBehavioural

    Also called Smoking Cessation Service Card

    The 3-folded "Smoking Cessation Services" card consists of brief information and highlights of existing smoking cessation services, contact methods, motivation information and strong supporting messages or slogans.

  • COSH Self-help smoking cessation bookletBehavioural

    A general smoking cessation self-help booklet

Study groups in NCT04399967
Study groupRoleWhat they receive
Intervention GroupExperimentalChat-based support+ COVID-19 specific advice + AWARD advice + COVID-related health warning leaflet + referral card + COSH booklet
Receives: Behavioral: Chat-based support; Behavioral: AWARD plus COVID-specific advice; Behavioral: COVID-19 related health warning leaflet; Behavioral: Referral card; Behavioral: COSH Self-help smoking cessation booklet
Control GroupExperimentalText-based support + AWARD advice + warning leaflet + referral card + COSH booklet
Receives: Behavioral: AWARD advice; Behavioral: Health warning leaflet; Behavioral: SMS-based support; Behavioral: Referral card; Behavioral: COSH Self-help smoking cessation booklet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Biochemical validated quit rate

    The primary outcomes are biochemically validated quit rates (exhaled CO < 4 ppm or salivary cotinine < 30 ng/ml) at 3-month in the two groups

    Measured: 3-month follow-up

  2. Biochemical validated quit rate

    The primary outcomes are biochemically validated quit rates (exhaled CO < 4 ppm or salivary cotinine < 30 ng/ml) at 6-month in the two groups

    Measured: 6-month follow-up

Secondary outcomes (5)

  1. Smoking quit rate change from baseline at 3-month follow-up

    Self-reported 7-day point prevalence (pp) quit rate at 3-month between the two groups

    Measured: 3-month follow-up

  2. Smoking quit rate change from baseline at 6-month follow-up

    Self-reported 7-day point prevalence (pp) quit rate at 6-month between the two groups

    Measured: 6-month follow-up

  3. Smoking reduction rate change from baseline at 3-month follow-up

    Rate of smoking reduction by at least half of baseline amount in the two groups

    Measured: 3-month follow-up

  4. Smoking reduction rate change from baseline at 6-month follow-up

    Rate of smoking reduction by at least half of baseline amount in the two groups

    Measured: 6-month follow-up

  5. Engagement in chat-based/text-based support

    Self-reported engagement in chat-based/SMS-based support in the two groups

    Measured: 3 and 6 months follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2020
  2. Study start13 Jun 2020
  3. Primary completion30 Jun 2021
  4. Study completion30 Jun 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
1,166 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04399967
Sponsor's protocol ID
QTW 2020
Acronym
QTW2020
Status last verified
May 2023
First submitted
19 May 2020
Last updated
23 May 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zeng Y, Wu YS, Luk TT, Zhao SZ, Guo Z, Li Y, Tong HSC, Lai VWY, Cheung YTD, Lam TH, Wang MP. Quitting trajectories of Hong Kong Chinese smokers receiving behavioral smoking cessation interventions: A post hoc analysis of eight randomized controlled trials. Addiction. 2026 Jun;121(6):1568-1579. doi: 10.1111/add.70328. Epub 2026 Jan 17.

    PubMed 41546550

  • Weng X, Luk TT, Wu YS, Zhao SZ, Cheung DYT, Tong HSC, Lai VWY, Lam TH, Wang MP. Effect of smoking-related COVID-19 risk messaging on smoking cessation in community smokers: A pragmatic randomized controlled trial. Tob Induc Dis. 2023 Jun 14;21:77. doi: 10.18332/tid/163176. eCollection 2023.

    PubMed 37323509

Questions about this trial

What is this clinical trial studying?

A study testing Chat-based support, AWARD plus COVID-specific advice and AWARD advice in people with Smoking Cessation, run by The University of Hong Kong at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 May 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Biochemical validated quit rate (time frame: 3-month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04399967, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2023.

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