Sains Malaysiana 49(8)(2020): 1995-2003

http://dx.doi.org/10.17576/jsm-2020-4908-22

Effects of Aided Smoking Cessation Counselling with Exhaled Carbon Monoxide Measurement versus Conventional Counselling on Smokers' Intention to Quit and Cigarette Consumption

(Kesan Bantuan Kaunseling Berhenti Merokok dengan Ukuran Hembusan Karbon Monoksida berbanding Kaunseling Konvensional terhadap Niat Perokok untuk Berhenti dan Penggunaan Rokok)

NOORSYARIDA SHADAN¹, HIZLINDA TOHID²*, CHAI-ENG TAN², NURAIDA BAHARUDDIN², NOOR AZIMAH MUHAMMAD² & SHAMSUL AZHAR SHAH³

¹Klinik Kesihatan Seberang Jaya, Ministry of Health Malaysia, Jalan Perpustakaan, 13700 Butterworth, Pulau Pinang, Malaysia

²Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

³Department of Public Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

Diserahkan: 26 November 2019/Diterima: 6 April 2020

ABSTRACT

Feedback on exhaled carbon monoxide (CO) levels may potentially improve smokers’ motivation to quit. However, evidence to support its use is still lacking. This study aimed to examine how providing feedback on exhaled CO measurement affected smokers’ intention to quit and cigarette consumption short term. This non-randomised controlled trial was conducted at a government health clinic. The control group (n=132) received conventional counselling using the 5A approach and pamphlets, whereas the intervention group (n=132) received similar counselling along with feedback on exhaled CO measurements. Subjects’ intention to quit in the next month and current cigarette consumption were assessed at baseline and again four weeks post-counselling. At the baseline, there were significant differences between the groups in terms of gender (p=0.002), ethnicity (p=0.004), marital status (p=0.002), age of smoking initiation (p<0.001), nicotine dependence (p=0.001) and quit intention (p<0.001). Compared to the control group, those who received intervention started smoking at a younger age and had greater nicotine dependence, but they had stronger quit intentions. One month post-counselling, there were no differences in quit intention (p=0.389) and cigarette consumption (p=0.902) between the groups. However, within-group analysis shows both a significant improvement in quit intention (p<0.001 for both groups) and a reduction in cigarette consumption (p<0.001 for both groups) after the counselling. None of the participants quit smoking at follow-up. In conclusion, both conventional smoking cessation counselling and counselling with feedback on exhaled carbon monoxide levels were similarly effective in improving smokers’ quit intention and reducing cigarette consumption. However, this enhanced motivation was inadequate to make them quit.

Keywords: Carbon monoxide; counselling; intention; smoking cessation; tobacco use

ABSTRAK

Maklum balas mengenai paras karbon monoksida (CO) yang dihembus perokok berpotensi untuk mempengaruhi motivasi perokok untuk berhenti merokok tetapi keberkesanan kaedah ini masih kekurangan bukti. Kajian ini bertujuan untuk meneliti bagaimana maklum balas terhadap ukuran hembusan CO dapat menyebabkan perokok berniat untuk berhenti merokok dan mengurangkan pengambilan rokok dalam jangka pendek. Kajian terkawal yang tidak rawak telah dijalankan di klinik kesihatan kerajaan. Kumpulan terkawal (n=132) menerima kaunseling konvensional menggunakan kaedah 5A dan risalah manakala kumpulan intervensi (n=132) menerima kaunseling yang sama dan maklum balas terhadap ukuran hembusan CO. Subjek yang berniat untuk berhenti merokok pada bulan berikutnya dan pengambilan rokok yang dihisap telah dinilai pada permulaan kajian dan dinilai sekali lagi empat minggu selepas kaunseling. Pada permulaan kajian, terdapat perbezaan yang ketara antara kumpulan daripada segi jantina (p=0.002), bangsa (p=0.004), status perkahwinan (p=0.002), umur mula merokok (p<0.001), kebergantungan kepada nikotin (p=0.001) dan niat untuk berhenti merokok (p<0.001). Berbanding dengan kumpulan terkawal, mereka yang menerima intervensi mula merokok pada usia yang muda dan mempunyai kebergantungan nikotin yang tinggi, tetapi mereka mempunyai niat untuk berhenti merokok yang lebih tinggi. Sebulan selepas sesi kaunseling, tiada perbezaan dari segi antara niat perokok untuk berhenti merokok (p=0.389) dan bilangan rokok yang dihisap (p=0.902) antara kumpulan intervensi dengan kumpulan kawalan. Namun, analisis dalam kumpulan menunjukkan bahawa kedua-dua kumpulan ini mempunyai peningkatan yang ketara dari segi niat untuk berhenti merokok (p<0.001 untuk kedua-dua kumpulan) dan pengurangan pengambilan rokok (p<0.001 untuk kedua-dua kumpulan) selepas sesi kaunseling. Pada penilaian susulan selepas sebulan, tiada perokok yang telah berjaya berhenti merokok. Kesimpulannya, kedua-dua kaedah kaunseling biasa dan pemberian maklum balas berkenaan paras karbon monoksida dalam nafas yang dihembus adalah sama-sama berkesan untuk meningkatkan niat berhenti merokok dan mengurangkan bilangan rokok yang dihisap. Namun, peningkatan niat berhenti merokok ini masih belum berjaya untuk menggerakkan perokok untuk berhenti merokok.

Kata kunci: Berhenti merokok; karbon monoksida; kaunseling; keinginan; penggunaan tembakau

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*Pengarang untuk surat-menyurat; email: hizlinda2202@gmail.com