Research article

Effectiveness of a mobile smoking cessation service in reaching elderly smokers and predictors of quitting

Abu Saleh M Abdullah^1,2 , Tai-Hing Lam² , Steve KK Chan² , Gabriel M Leung² , Iris Chi³ , Winnie WN Ho^2,5 and Sophia SC Chan⁴

¹Department of International Health, Boston University School of Public Health, Boston, Massachusetts, USA

²Department of Community Medicine, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, PR China

³School of Social Work, University of Southern California, Los Angela, USA

⁴Department of Nursing Studies, Li Ka Sing Faculty of Medicine, The University of Hong Kong, Hong Kong, PR China

⁵Department of Social Work, Hong Kong Baptist University, Hong Kong, PR China

author email corresponding author email

BMC Geriatrics 2008, 8:25doi:10.1186/1471-2318-8-25

Published:	6 October 2008

Abstract

Background

Different smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting.

Methods

The Mobile Smoking Cessation Programme (MSCP) targeted elderly smokers (aged 60 or above) and provided service in a place that was convenient to the elderly. Trained counsellors provided individual counselling and 4 week's free supply of nicotine replacement therapy (NRT). Follow up was arranged at 1 month by face-to-face and at 3 and 6 months by telephone plus urinary cotinine validation. A structured record sheet was used for data collection. The service was evaluated in terms of process, outcome and cost.

Results

102 governmental and non-governmental social service units and private residential homes for the elderly participated in the MSCP. We held 90 health talks with 3266 elderly (1140 smokers and 2126 non-smokers) attended. Of the 1140 smokers, 365 (32%) received intensive smoking cessation service. By intention-to-treat, the validated 7 day point prevalence quit rate was 20.3% (95% confidence interval: 16.2%–24.8%). Smoking less than 11 cigarettes per day and being adherent to NRT for 4 weeks or more were significant predictors of quitting. The average cost per contact was US$54 (smokers only); per smoker with counselling: US$168; per self-reported quitter: US$594; and per cotinine validated quitter: US$827.

Conclusion

This mobile smoking cessation programme was acceptable to elderly Chinese smokers, with quit rate comparable to other comprehensive programmes in the West. A mobile clinic is a promising model to reach the elderly and probably other hard to reach smokers.