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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 2009 UKM 8 – 9 August 2009
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Page 1: Quit Smoking An Intervention Study Among Army

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

Page 2: Quit Smoking An Intervention Study Among Army

Introduction

Page 3: Quit Smoking An Intervention Study Among Army

Facts: Smoking among Army in Kelantan

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

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Success story…

Source: Canoe Online Explorer (2002)

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Objective

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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

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Baseline

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

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Integrative approach: Motivation camp

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Motivation campEx-smoker experienceEx-smoker experience

Support by boss

Support by boss

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Integrative approach: Health talk & Forum

Panel:• Health Director Arm Forces

•Religious teacher•Counselor

Panel:• Health Director Arm Forces

•Religious teacher•Counselor

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Page 13: Quit Smoking An Intervention Study Among Army

Integrative approach:Weekly quit smoking clinic

•Group counseling

•Individual counseling

•Pharmacotherapy

•Group counseling

•Individual counseling

•Pharmacotherapy

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Continuous motivation & support

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• 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.

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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%]

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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%]

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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%]

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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

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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

Page 21: Quit Smoking An Intervention Study Among Army

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)

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Reasons for…

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Discussion: Integrative approach

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Discussion

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Conclusion

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Benowtz, N.L.(1983). The use of biologic fluid samples in assessing tobacco smoke consumption. In: Grabowski, J.,Bell. C.S. (eds) Measurement in the analysis and treatment smoking behavior. National Institute on Drug Abuse Research Monograph 48, U.S. Department of Health and Human Services, Rockland MD.

Bobo, J.K (1997). Primary Care for Women: Smoking, Alcohol Use, and Cessation techniques. Philadelphia: Leppert, P.C., & Howard. F. M.

Chapman, S. & Wong, W. L (1990). Tobacco Control in the Third World A Resource Atlas. Penang: IOCU.

Dr. Fauziah Mohd. Nor , KPP Epidemiologi (Non CDC), Jabatan Kesihatan Negeri Kelantan

Pruitt, B.E (1998) Health Styles: A Decision for Living Well. 2rd Ed. Allyn and Bacon Ray, Oakley Stern (1999) Drugs, soceity, and human behavior. 8th Ed.. WBC/Mc Graw Hill.

Jarvis, MJ., Tunstall-Pedoe, H., Feyerabend, C., Saloogee, Y. (1984).Biochemical markers of smoke absorption and self-reported exposure to passive smoking> J. Epidemiol. Commun. Health. 38:335-339

Nurul Adlina, H. (1994). Gadis Sasaran Firma rokok. Berita harian. (2001

Risalah: Asap Maut mengancam Nyawa Anda: Amalkan Cara Hidup Sihat, Jantung untuk Kehidupan (2001), Bahagian Pendidikan Kesihatan, Kementerian Kesihatan Malaysia)

Surgeon General Report,. (2001). Women and Smoking; A Report of the Surgeon general 2001.

l

References

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