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      Effectiveness of an employment-based smoking cessation assistance program in China

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          Objective: The objective of this study was to adapt an evidence-based smoking cessation intervention initially developed in the United States to the Chinese context and evaluate the effectiveness of this intervention in China.

          Method: A smoking cessation program from United States was adapted and implemented through an Employee Assistance Program (EAP) in China. The intervention consisted of recommending medication and psychological counseling. Local EAP counselors received training on the program and delivered the intervention to clients. Program evaluation examined the intervention's effectiveness in helping clients quit or reduce the amount of smoking and nicotine dependence.

          Results: Ninety-day follow-up showed that those who had completed the program were more likely to remain abstinent, or stop smoking daily and have lower levels of nicotine dependence ( p < 0.05) than those who had dropped out.

          Conclusions: The evidence-based cessation program is effective in helping Chinese smokers quit or reduce the amount of smoking. Moreover, implementing such programs in an EAP setting is a practical approach to providing a wider spectrum of smokers with access to cessation assistance in China.

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          Most cited references 23

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

           A. Hedley,  ,  Tai Lam (2005)
          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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            Smoking Cessation Guidelines for Health Professionals---A guide to effective smoking cessation interventions for the health care system

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              Economic burden of smoking in China, 2000.

              To assess the health-related economic burden attributable to smoking in China for persons aged 35 and older. A prevalence-based, disease-specific approach was used to estimate the smoking attributable direct costs, indirect morbidity costs, and costs of premature deaths caused by smoking-related diseases. The primary data source was the 1998 China National Health Services Survey, which contains the smoking status, medical utilisation, and expenditures for 216,101 individuals. The economic costs of smoking in 2000 amounted to $5.0 billion (measured in 2000, USD) in total and $25.43 per smoker (> or = age 35). The share of the economic costs was greater for men than women, and greater in rural areas than in urban areas. Of the $5.0 billion total costs, direct costs were $1.7 billion (34% of the total), indirect morbidity costs were $0.4 billion (8%), and indirect mortality costs were $2.9 billion (58%). The direct costs of smoking accounted for 3.1% of China's national health expenditures in 2000. The adverse health effects of smoking constitute a huge economic burden to the Chinese society. To reduce this burden in the future, effective tobacco control programmes and sustained efforts are needed to curb the tobacco epidemic and economic losses.

                Author and article information

                Family Medicine and Community Health
                Compuscript (Ireland )
                March 2015
                April 2015
                : 3
                : 1
                : 53-62
                1Chestnut Global Partners, China, Shanghai, China
                2Healthcare Performance Consulting representing Cease Smoking Today, Indianapolis, Indiana, USA
                3Chestnut Global Partners, Bloomington, Illinois, USA
                Author notes
                CORRESPONDING AUTHOR: Peizhong Li, 555 West Guangzhong Road, Shanghai, China 200072, E-mail: Lipeizhong@ 123456eapchina.net
                Copyright © 2015 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                Self URI (journal page): http://fmch-journal.org/
                Section Two: Population Health Management for General Practitioners


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