Media

HKU Youth Quitline Smoking Cessation Hotline Helps a Quarter of the Participants Quit Smoking and Reduce Youth Smokers’ Depressive Mood

10 Nov 2016

(From left) Miss Christy Lau, Peer Smoking Cessation Counsellor of HKU “Youth Quitline”; HKU “Youth Quitline” Participant Danny; Professor Lam Tai-hing, Sir Robert Kotewall Professor in Public Health and Chair Professor of Community Medicine, School of Public Health, Li Ka Shing Faculty of Medicine, HKU; Dr William Li Ho-cheung, Project Director of the “Youth Quitline” and Associate Professor of School of Nursing, Li Ka Shing Faculty of Medicine, HKU; Ms Vienna Lai, Executive Director of Hong Kong Council on Smoking and Health.

Since its establishment in 2005, “Youth Quitline” has helped nearly a quarter of the participants quit smoking at the 6-month follow-up and helped participants who did not quit smoking reduce cigarette consumption.  The University of Hong Kong (HKU) found that over 40% of the participants had mild or notable depressive mood and unhealthy lifestyle.  After receiving telephone counselling, participants were more confident in quitting smoking with less depressive mood.

“Youth Quitline” and its effectiveness

The smoking cessation hotline “Youth Quitline”, jointly established by the Smoking Cessation Research Team of School of Nursing of Li Ka Shing Faculty of Medicine, School of Public Health of Li Ka Shing Faculty of Medicine and Department of Social Work and Social Administration, HKU, and the Hong Kong Council on Smoking and Health in 2005, is the first youth-oriented smoking cessation hotline in Hong Kong.  “Youth Quitline” has been funded by the Tobacco Control Office under Department of Health since October 2011 and it has been awarded the funding for the third period. 

“Youth Quitline” has answered 9,267 telephone enquiries and provided smoking cessation counselling for 1,952 youth smokers.  The counselling service of the Quitline effectively increased the knowledge of the health risks of smoking of the participants (increased by 10.1%) and quitting intention (increased by 5%); reduced quitting difficulties (reduced by 7%) and depressive mood (reduced by 15%).  Since the establishment of the Quitline, 23.5% participants had successfully quit smoking at the 6-month follow-up and 11.5% of them reduced their cigarette consumption at least by half.

Smoking profile of youth smokers in the smoking cessation programme

In 2016 (January 1 – July 31), 162 participants joined the programme in total.  Of them, over 80% of the participants were male, and the mean age was 19.9 years.  Over 60% of the participants were full-time students.  Similar to past years, both male and female smokers consumed 10 cigarettes per day on average and had mild nicotine dependence.  Nearly half of the participants quit smoking because they wanted “to live a healthy lifestyle” (49.2%), followed by “illness or problems with personal health” (28.9%) and “save money” (25.8%).

Quit smoking and healthy lifestyle (Data from November 1, 2011 to July 31, 2016, 1,147 participants in total)

Depressive mood of participants

43% of the participants had depressive mood, and 9% of them had notable depressive mood.  Youth smokers with depressive mood were more likely to perceive smoking cessation as more difficult and had lower confidence in quitting.  They perceived daily life stress as the barrier to quit smoking.  Moreover, daily cigarette consumption and nicotine dependence level were significantly associated with increased level of depressive mood.

Daily habits of participants

About one-third of the participants smoked more than 10 cigarettes per day, and the same proportion drank at least once a week.  Over 60% of the participants also reported that drinking would lead to more cigarette consumption.  More drinkers were found in those who smoked more. Participants who smoked more did less exercises.  About 40% of the participants who smoked more than 10 cigarettes per day did not perform any physical activity in the past 7 days at the follow-up.

Dr William Li Ho-cheung, Project Director of the “Youth Quitline” and Associate Professor of School of Nursing, Li Ka Shing Faculty of Medicine, HKU, stated that participants with depressive mood had a higher daily cigarette consumption.  Youth smokers with more cigarette consumption tended to adopt an unhealthy lifestyle.  Therefore, apart from encouraging participants to quit smoking as early as possible, it is also essential to deliver healthy lifestyle messages including recommendations related to both psychological and physical health such as stress management, less drinking and more exercise.  These could largely enhance the effectiveness in smoking cessation and relapse prevention.

The use of electronic cigarette among the “Youth Quitline” participants

From January 2013 to April 2016, “Youth Quitline” counselled 622 youth smokers. Among them, 469 reported questions on knowledge, attitude and practice of using e-cigarette. 227 males and 49 females had used e-cigarette, accounting for 44% of 622 youth smokers and nearly 60% of 469 reported e-cigarette questions. Younger participants had higher prevalence of e-cigarette use. Youths who had used e-cigarette (“users”) were aged 17.8 on average, which was significantly lower than the non-users (19.2 years on average).

Of those participants who bought e-cigarettes by themselves, nearly half purchased it from consignment store.  Over 40% of the users were not sure whether their e-cigarettes contained nicotine.  About one-third of the users thought that using e-cigarette can help quit smoking or reduce cigarette consumption.  

E-cigarette users had lower confidence in quitting than non-users.  The nicotine dependence level of users was also significantly higher than non-users.  There was no significant difference in smoking cessation rates between users and non-users at the 6-month follow-up, suggesting that using e-cigarette could not increase smoking cessation.

The Way Forward

Professor Lam Tai-hing, Sir Robert Kotewall Professor in Public Health and Chair Professor of Community Medicine, School of Public Health, Li Ka Shing Faculty of Medicine, HKU advised increasing public awareness including youths and their parents about the health risks and other hazards (such as explosion) of using e-cigarette.  Meanwhile, government should enact legislation banning the e-cigarettes.

Dr William Li Ho-cheung hopes to increase the awareness of the public and smokers towards “Youth Quitline” through different media, so that more youth smokers can receive support and counselling.  “Youth Quitline” has just updated its website last month with more smoking cessation information.  It will also increase the coverage of the publicity materials in the coming year, strengthen the connection with schools and organisations and explore further the outreach opportunity, promoting “Youth Quitline” to reach and help more youth smokers and deliver more smoke-free messages to the community.

In order to further increase the quality of “Youth Quitline”, Dr Li stated that in-depth training on topics about emotion management skills and healthy lifestyle promotion will be provided to the smoking cessation counsellors during the counsellor training programme for continuous service improvement. 

About “Youth Quitline” 5111 4333

The Smoking Cessation Research Team of School of Nursing, Li Ka Shing Faculty of Medicine, HKU, in collaboration with the School of Public Health of Li Ka Shing Faculty of Medicine, the Department of Social Work and Social Administration of HKU and the Hong Kong Council on Smoking and Health, established the first youth-oriented smoking cessation hotline “Youth Quitline” in 2005.  “Youth Quitline” aims to raise the awareness of smoking cessation service among young people in Hong Kong and to provide free of charge smoking cessation service to youth smokers.  It also aims to provide training to young people as peer smoking cessation counsellors.  All these are always done together with vigorous research and evaluation to improve the Quitline service and generate new knowledge and evidence to support tobacco control.  “Youth Quitline” also proactively helps schools and other organisations to promote smoking cessation through outreach programmes.  “Youth Quitline” targets youth smokers aged 25 or below.  All young people are welcome to contact “Youth Quitline” through telephone, social media (WhatsApp, Facebook) or website (www.hku.hk/yquit) to join the smoking cessation programme.

Please visit the website at http://www.med.hku.hk/news/ for press photos and presentation slides. 

Dr William Li Ho-cheung, Project Director of the “Youth Quitline” and Associate Professor of School of Nursing, Li Ka Shing Faculty of Medicine, HKU says, “apart from encouraging youth smokers to quit smoking as early as possible, healthy lifestyle could largely enhance the effectiveness in smoking cessation and relapse prevention.” 

Professor Lam Tai-hing, Sir Robert Kotewall Professor in Public Health and Chair Professor of Community Medicine, School of Public Health, Li Ka Shing Faculty of Medicine, HKU advised increasing public awareness including youths and their parents about the health risks and other hazards of using e-cigarette.