Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Evaluation of the effectiveness of a WHO-5A model based comprehensive tobacco control program among migrant workers in Guangdong, China: a pilot study

Authors: Wenxin Chai, Guanyang Zou, Jingrong Shi, Wen Chen, Xiao Gong, Xiaolin Wei, Li Ling

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

As a vulnerable population in China, migrant workers have a higher smoking rate than the general population. This study aims to assess the effectiveness of a WHO-5A based comprehensive tobacco control program in workplaces aggregated with migrants.

Methods

Using a controlled before and after design, four purposely selected manufacturing factories were assigned to either intervention or control groups. Participants in the intervention arm received adapted 5A group counseling regularly supported by social-media and traditional health education approaches. The primary outcome was the change of smoking rate based on salivary cotinine concentration at three-month follow-up as compared to the control arm. Secondary outcomes were changes in smoking-related knowledge and attitudes assessed using questionnaires. Difference-in-differences approach (DID) and generalized estimating equations (GEE) models were used to conduct the effectiveness analysis.

Results

149 and 166 workers were enrolled in the intervention and control arm respectively. The multiple imputed and adjusted GEE models demonstrated that, compared to those in the control arm, participants in the intervention arm had nearly 2.4 times odds of improving smoking-related knowledge (OR = 2.40, 95% CI = 1.32–4.36, P = 0.02) and three times the odds of improving smoking-related attitude (OR = 3.07, 95% CI = 1.28–7.41, P = 0.03). However, no significant difference was found regarding the change of smoking rate between the two arms (P > 0.05). The regression analysis showed that attendance at the 5A group counseling sections was an important determinant of stopping smoking or improving smoking-related knowledge and attitudes in the intervention group.

Conclusions

This WHO-5A comprehensive intervention was effective in improving migrant workers’ knowledge of smoking and anti-smoking attitudes. A large-scale, long-term trial is recommended to determine the effectiveness of this intervention.

Trial registration

ChiCTR-OPC-17011637 at Chinese Clinical Trial Registry. Retrospectively registered on 12th June 2017.
Appendix
Available only for authorised users
Literature
1.
World Health Organization Global Health Risks: Mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization, 2010.
2.
World Health Organization. Global adult tobacco survey (GATS): China 2010 country report. Geneva: World Health Organization; 2010.
3.
4.
Fong GT, Sansone G, Yan M, Craig L, Quah ACK, Jiang Y. Evaluation of smoke-free policies in seven cities in China: longitudinal findings from the ITC China project (2007–2012), 2007-2012. Tob Control. 2015;24:14–20.CrossRef
5.
World Health Organization Smoke-free Policies in China: evidence of effectiveness and implications for action. Geneva, Switzerland: World Health Organization, 2015.
6.
National Health and Family Planning Commission of the PRC. Report on China's Migrant Population Development (2015). Beijing: China Population Publishing House; 2015.
7.
Huang Z, Wang L, Zhang M, Deng Q, Wang Z, Zhao Y, et al. Smoking behavior among the Chinese employed floating population aged 18-59 in 2012. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35:1192–7.PubMed
8.
Mou J, Fellmeth G, Griffiths S, Dawes M, Cheng J. Tobacco smoking among migrant factory workers in Shenzhen, China. Nicotine Tob Res. 2013;15:69–76.CrossRefPubMed
9.
Liu Y, Song H, Wang T, Yang H, Shen Y, Dai W, et al. Determinants of tobacco smoking among rural-to-urban migrant workers: a cross-sectional survey in shanghai. BMC Public Health. 2015;15:131.CrossRefPubMedPubMedCentral
10.
11.
Ali AK, Mohammed A, Thomas AA, Paul S, Shahul M, Kasim K. Tobacco abuse and associated oral lesions among interstate migrant construction workers. J Contemp Dent Pract. 2017;18(8):695–9.CrossRefPubMed
12.
13.
Thun, M. J., Carter, B. D., Feskanich, D., Freedman, N. D., Prentice, R., Lopez, A. D., Gapstur, S. M. (2013). 50-year trends in smoking-related mortality in the United States. N Engl J Med, 368(4), 351–364. Retrieved from https://​doi.​org/​10.​1056/​NEJMsa1211127.
14.
15.
Han YW, Mohammad M, Liew SM. Effectiveness of a brief physician counselling session on improving smoking behaviour in the workplace. Asian Pac J Cancer Prev. 2014;15:7287–90.CrossRefPubMed
16.
Mallin R. Smoking cessation: integration of behavioral and drug therapies. Am Fam Physician. 2002;65:1107–14.PubMed
17.
Kim A, Kamyab K, Zhu J, Volpp K. Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation. J Occup Environ Med. 2011;53:62–7.CrossRefPubMed
18.
Tanaka H, Yamato H, Tanaka T, Kadowaki T, Okamura T, Nakamura M, et al. Effectiveness of a low-intensity intra-worksite intervention on smoking cessation in Japanese employees: a three-year intervention trial. J Occup Health. 2006;48:175–82.CrossRefPubMed
19.
20.
Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: Department of Health and Human Services, 2008.
21.
World Health Organization, Toolkit for delivering the 5A's and 5R's brief tobacco interventions in primary care. Geneva, Switzerland: World Health Organization, 2014.
22.
Alomari MA, Khader YS, Dauod AS, Jordan TR, Khuder S. Smoking cessation counseling practices of family physicians in Jordan. J Natl Med Assoc. 2013;8:85–90.
23.
Simmons VN, Litvin EB, Unrod M, Brandon TH. Oncology healthcare providers’ implementation of the 5 A’s model of brief intervention for smoking cessation: patients’ perceptions. Patient Educ Couns. 2011;86:414–9.CrossRefPubMedPubMedCentral
24.
Liao J, Winickoff JP, Nong G, Huang K, Yang L, Zhang Z, et al. Are Chinese pediatricians missing the opportunity to help parents quit smoking? BMC Pediatr. 2016;16:135.CrossRefPubMedPubMedCentral
25.
World Health Organization, The bill China cannot afford. The health, economic, and social costs of China’s tobacco epidemic. Geneva, Switzerland: World Health Organization, 2017.
26.
27.
SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4:149–59.CrossRef
28.
29.
Vickers AJ, Altman DG. Statistics notes: missing outcomes in randomized trials. BMJ. 2013;346:f3438.CrossRefPubMed
30.
World Health Organization WHO Framework Convention on Tobacco Control. Geneva, Switzerland: World Health Organization, 2003.
31.
32.
33.
Mohammadnezhad M, Tsourtos G, Wilson C, Ratcliffe J, Ward P. “I have never experienced any problem with my health. So far, it hasn't been harmful”: older Greek-Australian smokers' views on smoking: a qualitative study. BMC Public Health. 2015;15:304.CrossRefPubMedPubMedCentral
34.
Intarut N, Chongsuvivatwong V, McNeil E. Effects of a school-based intervention program on attitude and knowledge of household members towards a smoke-free home: a cluster controlled trial. Asian Pac J Cancer Prev. 2016;17:1235–42.CrossRefPubMed
35.
Tahlil T, Woodman RJ, Coveney J, Ward PR. Six-months follow-up of a cluster randomized trial of school-based smoking prevention education programs in Aceh, Indonesia. BMC Public Health. 2015;15:1088.CrossRefPubMedPubMedCentral
36.
Wen X, Chen W, Gans KM, Colby SM, Lu C, Liang C, et al. Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial. Int J Epidemiol. 2010;39:860–76.CrossRefPubMedPubMedCentral
37.
Rollins C, Glass NE, Perrin NA, Billhardt KA, Clough A, Barnes J,et al. Housing instability is as strong a predictor of poor health outcomes as level of danger in an abusive relationship: findings from the SHARE study. J Interpers Violence 2012; 27: 623–43.
38.
Okechukwu CA, Krieger N, Sorensen G, Li Y, Barbeau EM. Effectiveness of an apprenticeship site-based smoking cessation intervention for unionized building trade workers. Cancer Causes Control. 2009;20:887–94.CrossRefPubMedPubMedCentral
39.
Bergström G, Björklund C, Fried I, Lisspers J, Nathell L, Hermansson U, et al. A comprehensive workplace intervention and its outcome with regard to lifestyle, health and sick leave: the AHA study. Work. 2008;31:167–80.PubMed
40.
Kadowaki T, Okamura T, Funakoshi T, Okayama A, Kanda H, Miyamatsu N, et al. Effectiveness of annual interventions for smoking cessation in an occupational setting in Japan. Environ Health Prev Med. 2004;9(4):161.CrossRefPubMedPubMedCentral
41.
Iliceto P, Fino E, Pasquariello S, D’ Angelo Di Paola ME, Enea D. Predictors of success in smoking cessation among Italian adults motivated to quit. J Subst Abus Treat. 2013;44:534–40.CrossRef
42.
Dorner T, Tröstl A, Womastek I, Groman E. Predictors of short-term success in smoking cessation in relation to attendance at a smoking cessation program. Nicotine Tob Res. 2011;13:1068–75.CrossRefPubMed
43.
Yong HH, Hamann SL, Borland R, Fong GT, Omar M, project team ITC-SEA. Adult smokers' perception of the role of religion and religious leadership on smoking and association with quitting: a comparison between Thai Buddhists and Malaysian Muslims. Soc Sci Med. 2009;69:1025–31.CrossRefPubMedPubMedCentral
44.
Hagimoto A, Nakamura M, Morita T, Masui S, Oshima A. Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up study. Addiction. 2009;105:164–73.CrossRefPubMed
45.
Hellman R, Cummings KM, Haughey BP, Zielezny MA, O'Shea RM. Predictors of attempting and succeeding at smoking cessation. Health Educ Res. 1991;6:77–86.CrossRefPubMed
46.
Vangeli E, Stapleton J, Smit ES, Borland R, West R. Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction. 2016;106:2110–21.CrossRef
47.
Spicer RS, Miller TR. The evaluation of a workplace program to prevent substance abuse: challenges and findings. J Prim Prev. 2016;37:329–43.CrossRefPubMed
48.
Metadata
Title
Evaluation of the effectiveness of a WHO-5A model based comprehensive tobacco control program among migrant workers in Guangdong, China: a pilot study
Authors
Wenxin Chai
Guanyang Zou
Jingrong Shi
Wen Chen
Xiao Gong
Xiaolin Wei
Li Ling
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5182-6

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations

Study protocol

Effectiveness of a diabetes prevention program for rural women with prior gestational diabetes mellitus: study protocol of a multi-site randomized clinical trial

Research article

Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers

Research article

Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: changes in health cognitions and glycemic control

Research article

Vaccine wastage in The Gambia: a prospective observational study

Research article

Factors influencing the use of contraceptives through the lens of teenage women: a qualitative study in Iran