Adherence to nicotine replacement therapy versus quitting smoking among Chinese smokers: A preliminary investigation

Department of Community Medicine, The University of Hong Kong, Hong Kong, China.
Psychopharmacology (Impact Factor: 3.99). 03/2005; 177(4):400-8. DOI: 10.1007/s00213-004-1971-y
Source: PubMed

ABSTRACT There are over 300 million Chinese smokers, but use of nicotine replacement therapy (NRT) is rare. On the other hand, data on the factors associated with quitting and adherence to NRT use are scarce in the East.
To describe adherence and other predictors of quitting smoking at the 12-month follow-up amongst Chinese smokers in Hong Kong.
Chinese smokers (1186) who attended the Smoking Cessation Health Centre from August 2000 through January 2002 were studied. Trained counsellors provided individual counselling and carried out follow-up interviews. We used structured questionnaires at baseline and at 1, 3 and 12 months and an intention-to-treat approach for analysis.
Among those who received NRT (1051/1186), the prevalence of adherence (self-reported NRT use for at least 4 weeks) was 16% (95% confidence interval 14-18%). The 7-day point prevalence quit rate at 12 months (not smoking any cigarette during the past 7 days at the 12 month follow-up) was 27% (95% CI, CI 24-29%). Stepwise logistic regression model showed that adherence to NRT use, a higher income, good perceived health and having more confidence in quitting were significant predictors of quitting. The quit rate in the adherent group (40%) was greater than that of the non-adherent group (25%) (P<0.001). Older age, male, higher education, experience of NRT use, perceiving quitting as more difficult and willingness to pay were significant predictors of adherence.
Clinically significant smoking cessation rates can be achieved among Chinese smokers in a clinic-based smoking cessation service. The NRT adherence was low and low adherence was associated with a lower quit rate. Trials of interventions to improve adherence and increase quit rates are needed.

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    • "Although a higher proportion in the A2 group used NRT for at least 2 weeks probably due to the free supply, there was no impact on the reported overall quit rates. One possible explanation was that giving 1- week or 2-week free NRT did not change smokers' adherence to NRT use (defined as NRT use for 4 weeks or longer [20]), as the prevalence of NRT use was almost identical in both groups, (22.9% in A1 group versus 24.8% in A2 group). Another explanation was that 1-week free NRT was enough to encourage motivated smokers to continue to use it for a longer duration, because some smokers who attended the clinic were already motivated to quit and giving 1-week or 2-week supply did not have any measurable effect on their determination to quit and buy NRT afterwards. "
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    ABSTRACT: This study examined if 2-week free nicotine replacement therapy (NRT) would be more effective than 1-week free NRT to help smokers quit smoking at 6 and 12 months. In a single-blinded randomized controlled trial design, 562 Chinese smokers who attended a smoking cessation clinic in Hong Kong, China, were randomly allocated into two groups (A1 and A2): A1 (n = 284) received behavioural counselling with free NRT for 1 week; A2 (n = 278) received similar counselling with free NRT for 2 weeks. All subjects received printed self-help materials to support their quitting efforts. A structured questionnaire was used for data collection, including pattern of NRT use and self-reported 7-day point prevalence quit rate at 6 months and 12 months. Among the participants, the mean number of cigarettes smoked per day was 18.8 (SD = 10.9). By intention-to-treat analysis, 7-day point prevalence quit rates were not significantly different between A1 and A2 groups at 6-month (27.5% versus 27.3%; P = 0.97) and 12-month (21.1% versus 21.2%; P = 0.98) followup. The findings suggest that two-week free NRT was not more effective than 1-week free NRT to increase smoking cessation rate among Chinese smokers.
    09/2013; 2013:961751. DOI:10.1155/2013/961751
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    • "Higher rates of bupropion adherence are associated with an increased likelihood of smoking abstinence (Killen et al., 2004; Mooney, Sayre, Hokanson, Stotts, & Schmitz, 2007; Schmitz, Stotts, Mooney, DeLaune, & Moeller, 2007; Swan, Javitz, Jack, Curry & McAfee, 2004). Many smokers, however, demonstrate poor adherence by taking inadequate doses or stopping use prematurely (Hurt et al., 1997; Lam, Abdullah, Chan, & Hedley, 2005; reviewed in Waldroup, Gifford, & Kalra, 2006). Moreover, adherence appears to decrease progressively over time (Waldroup et al., 2006). "
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    ABSTRACT: Beliefs about medication are associated with treatment adherence and outcome. This is a secondary analysis of the role of beliefs and attitudes about bupropion in treatment adherence and smoking cessation outcomes using data from a smoking cessation trial of open-label sustained-release (SR) bupropion therapy reported previously (Toll et al., 2007). Positive beliefs and attitudes were positively correlated with intentions, desire, confidence, and motivation to quit smoking; expectation of quitting success; perceived benefits of quitting; and perceived disadvantages of smoking. Positive beliefs were also associated with greater medication adherence, an increased likelihood of completing treatment and being continuously abstinent, and a delayed latency to smoking lapse. These findings provide preliminary support that positive beliefs and attitudes about bupropion are associated with positive attitudes toward quitting, better treatment adherence, and potentially better treatment response.
    Psychology of Addictive Behaviors 07/2009; 23(2):373-9. DOI:10.1037/a0015695 · 2.09 Impact Factor
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    • "Providing NRT to heavy smokers is needed. We can learn the Hong Kong SCHC experience: giving NRT free for one week and then ask the smokers to buy NRT for the rest of the regimen (Lam, et al.2005). This is probably the best approach, given that total subsidy for the whole course of NRT from government is unlikely in the near future. "
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