Ningyuan Guo
My name is Ningyuan Guo, PhD candidate from School of Nursing, University of Hong Kong. My PhD training focuses on addiction research, with broader interests in tobacco and alcohol dependence as well as behavioral addictions such as internet gaming disorder and internet addictions. I have engaged in several studies examining behavioral and psychosocial determinants of addictions and associated health outcomes, using different study designs including large population-based survey, prospective cohort study, and ecological momentary assessment. I am now engaging in an ongoing randomized controlled trial for smoking cessation among community smokers in Hong Kong. The trial delivered evidence-based text message behavioral support using instant messaging applications (WhatsApp). We also developed and used an artificial intelligence-powered chatbot to provide automatic responses to smokers, acting as a supplement of human smoking cessation advisors on WhatsApp. The trial would advance smoking cessation research in the era of rapid development of information communication technologies.
Intervention combining interactive communication technologies and nicotine replacement therapy sampling for proactively recruited smokers in smoking hotspots in Hong Kong: preliminary analysis of a pragmatic randomized controlled trial
Aims: Brief advice combined with active referral to smoking cessation (SC) services increase quitting. We strengthened and assessed the effect of combining interactive communication technologies and nicotine replacement therapy sampling (NRT-S) on SC.
Methods: We conducted a two-group, individually-randomized controlled trial in adult daily cigarette smokers proactively recruited in outdoor smoking hotspots in Hong Kong (ClinicalTrials.gov: NCT04001972). Both groups received face-to-face brief advice and referral to SC services using AWARD (Ask, Warn, Advise, Refer, Do-it-again) model. The Intervention group received 1-week free NRT-S at baseline and 12-week personalized behavioral support comprising regular tailored messages on abstinence using Instant Messaging (IM, e.g., WhatsApp), synchronous IM conversations with trained SC advisors, and a web-based Chatbot. The Control group received regular Short-Message-Service messages of similar intensity on general health and reminders for follow-up. Primary outcomes were carbon monoxide-validated smoking abstinence at 6-month and 12-month post-treatment initiation.
Results: 664 participants (332 each group, 74.4% male, 36.2% aged >40) were recruited during August 2019 – May 2020. Ongoing follow-ups are expected to end in May 2021. At baseline, participants smoked 11.0 (SD 6.3) cigarettes per day, 51.7% were not ready to quit within 30 days. The two groups showed similar sociodemographic, smoking and quitting-related characteristics (P 0.09 – 0.92). 35.1% were referred to SC services (Intervention 38.9% vs Control 31.3%, P=0.04). Of the Intervention group, 85.4% received 1-week NRT-S, 16.3% engaged in IM conversations, and 10.8% used the chatbot with 524 interactions observed.
Conclusions: Technology-enhanced combined interventions plus NRT-S are acceptable to community smokers in Hong Kong.