QUIT SMOKING: AN INTERVENTION STUDY AMONG ARMY

QUIT SMOKING: AN INTERVENTION STUDY AMONG ARMY

MZ Rehanah, AA Ismail, YN Azwany, AB Isa, SH Noor, IA Filza, BM Zin

Third Malaysian Conference on Tobacco Control MCTC 2009UKM

8 – 9 August 2009

Introduction

Facts: Smoking among Army in Kelantan

Source: (Rehanah MZ, AA Ismail et all 2006)

Success story…

Source: Canoe Online Explorer (2002)

Objective

Methodology

First phase:Prevalence study [n=319]

Intervention Groupn=79 (Camp 1)

Intervention Groupn=79 (Camp 1)

Control Groupn=240

Control Groupn=240

Healthy LifestyleCampaign

Healthy LifestyleCampaign

Total quit smoking After 3,6,9 months (urine test)

& Fagerstrom score

Total quit smoking After 3,6,9 months (urine test)

& Fagerstrom score

Total quit smokingAfter 3,6,9 month (urine test)

& Fagerstrom score

Total quit smokingAfter 3,6,9 month (urine test)

& Fagerstrom score

Health Education and medication

Health Education and medication

Quit smoking

Baseline

Source: (Rehanah MZ, AA Ismail et all 2007)

Integrative approach: Motivation camp

Motivation campEx-smoker experienceEx-smoker experience

Support by boss

Support by boss

Integrative approach: Health talk & Forum

Panel:• Health Director Arm Forces

•Religious teacher•Counselor

Panel:• Health Director Arm Forces

•Religious teacher•Counselor

Integrative approach:Weekly quit smoking clinic

•Group counseling

•Individual counseling

•Pharmacotherapy

•Group counseling

•Individual counseling

•Pharmacotherapy

Continuous motivation & support

• Dosage Guide for Smokers

• The level of nicotine dependence based on Fagerstrom Score Nicotine Dependence Questionnaire (FNDQ)

• Nicorette 4mg -for heavy, highly dependent smokers

(e.g. smoke more than 25 or more cigarettes a day

& FNDQ score 6 & above)

• Nicorette 2mg -for occasional and regular smokers of less than

10 cigarettes or irregular smokers of 10-25

cigarettes a day & FNDQ score below 6.

• Dosage Guide for Smokers

• The level of nicotine dependence based on Fagerstrom Score Nicotine Dependence Questionnaire (FNDQ)

• Nicorette 4mg -for heavy, highly dependent smokers

(e.g. smoke more than 25 or more cigarettes a day

& FNDQ score 6 & above)

• Nicorette 2mg -for occasional and regular smokers of less than

10 cigarettes or irregular smokers of 10-25

cigarettes a day & FNDQ score below 6.

ALWAYS ENCOURAGE FIRST TIME USER TO CHEW ONE PIECE OF THE NICORETTE GUM IN FRONT OF YOU TO ENSURE THE RIGHT CHEWING TECHNIQUE IS USED.

ALWAYS ENCOURAGE FIRST TIME USER TO CHEW ONE PIECE OF THE NICORETTE GUM IN FRONT OF YOU TO ENSURE THE RIGHT CHEWING TECHNIQUE IS USED.

Outcome after 12 weeksQuit 10 [12.6%]

Reduce 1-2 sticks/day16 [20.3%]

Reduce 2-3 sticks/day38 [48.1%]

Defaulted 15 [19.0%]

Outcome after 24 weeks

Quit 19 [24.1%]

Reduce 1-2 sticks/day20 [25.3%]

Reduce 2-3 sticks/day15 [19.0%]

Defaulted 25 [31.6%]

Outcome after 32 weeks

Quit 39 [49.4%]

Reduce 1-2 sticks/day23 [29.1%]

Reduce 2-3 sticks/day12 [15.2%]

Defaulted 5 [6.3%]

DescriptiveVARIABLE QUITTERS

Mean (SD)NON-QUITTERSMean (SD)

P-value

Age (year sold)

28.7 (6.38) 29.1 (6.67) 0.760

Duration of service (months)

108.0 (67.28) 111.8 (76.24) 0.82

No of cig/day 13.7 (9.12) 14.9 (7.55) 0.58

Tried to quit 30 (48.4) 32 (51.6) 0.67

No. of visit 8.1 (5.58) 2.6 (2.26) <0.001

DescriptiveVARIABLE QUITTERS

Mean (SD)NON-QUITTERSMean (SD)

P-value

Body weight (kg)

69.2 (10.66) 68.1 (9.29) 0.617

Difference in body weight

0.1 (4.39) 0.2 (1.76) 0.774

Fagerstrom score

7.3 (14.74) 4.5 (1.93) 0.27

Nicotine gum/week (mg)

13.8 (15.43) 7.5 (6.32) <0.023

Quit based on addiction level

Fagerstrom score

Quit n (%)

Not quitn (%)

P-value

1-4 19 (54.3) 16 (45.7)0.4675 & above 18 (54.5) 15 (45.5)

Reasons for…

Discussion: Integrative approach

Discussion

Conclusion

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References