Effect of Smoking Cessation Interventions on Adult Tobacco Smokers in Colombo District, Sri Lanka

Abstract

Effective strategies are needed to improve the motivation of smokers to quit. The aim of the study was to assess the effect of a smoking cessation program among the selected smokers who live in peri-urban areas of the Colombo district. 180 smokers with a median age of 39.0±18.75(IQR)(years), were selected for a prospective follow-up from a previously recruited pool of 360 smokers. Counselling interventions were applied at two levels based on the WHO 5A and 5Rcounselling protocol. Previously analysed cardio-pulmonary test results were used to create a strong motivation to quit. Compliance for the first intervention was assessed after one week. Second interventions were delivered on the day of the first follow-up and compliance was re-assessed after one month. Smoking status was confirmed with the assessment of a smoking biomarker of carbon monoxide e-CO (ppm)and carboxyhaemoglobin (COHb%) with Smokerlyzer® (Bedfont Scientific, UK). The pre-intervention values were daily consumption of cigarettes 5.73±4.88(SD) sticks; e-CO7.0±8.0(IQR)(ppm), COHb1.75±1.44(IQR) (%). Among the selected 180 smokers, 156(86.7%) attended the first follow-up. There was a significant difference of all smoking variables at one week after the counselling compared to the baseline values; the number of cigarettes, (Z=-10.644, p<0.001), e-CO (Z=-9.626, p<0.001), and COHb%(Z=-9.466, p<0.001). Changes in the smoking variables between baseline and one month were assessed. Out of the 156 smokers who participated in the week one follow-up, 113(72.5%) males presented for follow-up conducted one month later. There was a significant difference in all smoking variables at one month following the cessation interventions when compared to the baseline values, including the number of cigarettes (Z=-9.077, p<0.001), CO (Z=-8.707, p<0.001), and COHb% (Z=-8.574, p<0.001). In conclusion, compliance with smoking cessation can be achieved with proper education, motivation, and follow-up.