Smoking Cessation Program for the Older Smokers

December 5, 2025 updated by: Prof. Wang Man-Ping, The University of Hong Kong

A Randomized 2 by 2 Factorial Trial on mHealth Support and Financial Incentives to Promote Smoking Cessation in Deprived Older Smokers

This study aims to assess the effect of mobile health (mHealth) support or financial incentives and their interactive intervention effect on smoking cessation (SC) in old smokers in Hong Kong (HK).

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Low-income older smokers are disproportionally harmed by tobacco use and the evidence of effectiveness of smoking cessation (SC) intervention for this deprived group is scarce. Leveraging evidence of effectiveness of mHealth support and financial incentives in other adults, the investigators propose a scalable mHealth and/or financial incentives model using age-friendly components for the deprived older smokers.

The 2x2 factorial design consists of 2 interventions, including (1) smartphone mHealth support by scheduled age-friendly multimedia e-messages and real-time personalized behavioral supports for 3 months, and (2) an escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.

The study aims to assess the effectiveness of two interventions and their interactive intervention effect.

Study Type

Interventional

Enrollment (Actual)

1200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong
        • School of Nursing, The University of Hong Kong

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Smokers aged 60 years or above;
  2. Currently smoking cigarettes or alternative tobacco products daily in the past 3 months with an exhaled carbon monoxide (CO) level ≥4ppm or salivary cotinine >30 ng/ml;
  3. Have a mobile phone that can receive short message/messaging Service (SMS) or instant messages (IM);
  4. Having a household monthly income lower than the median income of domestic household in Hong Kong

6. Hong Kong residents able to communicate in Chinese.

Exclusion Criteria:

  1. Smokers not physically nor mentally fit for communication;
  2. Smokers currently using SC services;
  3. Hospitalized smokers;
  4. Not having a mobile phone or perceived difficulty in using mobile phone or communication Apps

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mobile health group
Smartphone mHealth support for smoking cessation by scheduled age-friendly multimedia e-messages and real-time personalized behavioral supports for 3 months.
Behavioral: Mobile health support
  1. Brief smoking cessation advice
  2. Health warning leaflet
  3. Smoking cessation information booklet
  4. Referral card
  5. E-messages on SC-related information and details on community SC services for 3 months
  6. Acceptance and Commitment Therapy based real-time Chat-based support for 3 months
Experimental: Financial incentive group
An escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.
Behavioral: Financial incentive
  1. Brief smoking cessation advice
  2. Health warning leaflet
  3. Smoking cessation information booklet
  4. Referral card
  5. An escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.
Experimental: Combined intervention group
Smartphone mHealth support for smoking cessation by scheduled age-friendly multimedia e-messages and real-time personalized behavioral supports for 3 months and an escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.
Behavioral: Combine intervention
  1. Brief smoking cessation advice
  2. Health warning leaflet
  3. Smoking cessation information booklet
  4. Referral card
  5. E-messages on SC-related information and details on community SC services for 3 months
  6. Acceptance and Commitment Therapy based real-time Chat-based support for 3 months
  7. An escalating incentive scheme for smoking abstinence: HK$500 for using any SC services within 6 months, and HK$1000, 1500 and 2000 for biochemically validated abstinence at 3-, 6- and 12-month, respectively.
Active Comparator: Control group
Brief advice
Behavioral: Control group
  1. Brief smoking cessation advice
  2. Health warning leaflet
  3. Smoking cessation information booklet
  4. Referral card
  5. E-messages on SC-related information and details on community SC services for 3 months for those without abstinence at 12-month follow-up after follow-ups ending
  6. Acceptance and Commitment Therapy based rear-time Chat-based support for 3 months for those without abstinence at 12-month follow-up after follow-ups ending

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The biochemically validated smoking abstinence
Time Frame: the 6-month follow-ups
Smoking abstinence is defined by exhaled CO < 4 ppm and salivary cotinine <30 ng/ml
the 6-month follow-ups

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The biochemically validated smoking abstinence
Time Frame: the 3- and 12-month follow-ups
Smoking abstinence is defined by exhaled CO < 4 ppm and salivary cotinine <30 ng/ml
the 3- and 12-month follow-ups
Self-reported 7-day point-prevalence abstinence
Time Frame: 3-, 6-, and 12-month follow-ups
Smokers who did not smoke even a puff in the 7 days preceding the follow-up
3-, 6-, and 12-month follow-ups
Self-reported quit attempts
Time Frame: 3-, 6-, and 12-month follow-ups
Self-reported quit attempt
3-, 6-, and 12-month follow-ups
Smoking cessation services use
Time Frame: 3-, 6-, and 12-month follow-ups
Using the smoking cessation service from hospitals or government in Hong Kong
3-, 6-, and 12-month follow-ups
Self-reported intention to quit
Time Frame: 3-, 6-, and 12-month follow-ups
self-reported intention to quit in next days
3-, 6-, and 12-month follow-ups
Self-reported smoking change
Time Frame: 3-, 6-, and 12-month follow-ups
Self-reported change in number of cigarettes smoked daily of at least less 50% of the baseline number
3-, 6-, and 12-month follow-ups
Self-reported self-efficacy of quitting
Time Frame: 3-, 6-, and 12-month follow-ups
Self-reported self-efficacy of quitting includes the perception of quitting importance, difficulty and confidence, assessing by an item scaled with 0-10, respectively. The score of zero refers to very unimportant, very easy, or very unconfident. The score of 10 refers to very important, very difficult or very confident, respectively. Higher score refers to higher perception of quitting importance, difficulty and confidence.
3-, 6-, and 12-month follow-ups
Nicotine dependence level
Time Frame: 3-, 6-, and 12-month follow-ups
Fagerstrom Test for Nicotine Dependence (FTND)
3-, 6-, and 12-month follow-ups

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The University of Hong Kong

Collaborators

University Grants Committee, Hong Kong

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 20, 2024

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

January 22, 2024

First Submitted That Met QC Criteria

January 22, 2024

First Posted (Actual)

January 31, 2024

Study Record Updates

Last Update Posted (Estimated)

December 15, 2025

Last Update Submitted That Met QC Criteria

December 5, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SCFO

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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