Effectiveness of an individual acceptance and commitment therapy for smoking cessation, delivered face-to-face and by telephone to adults recruited in primary health care settings: a randomized controlled trial

Yim Wah Mak, Doris Y P Leung, Alice Yuen Loke, Yim Wah Mak, Doris Y P Leung, Alice Yuen Loke

Abstract

Background: The aim of this study was to examine the effectiveness of delivering an individual Acceptance and Commitment Therapy (ACT) for smoking cessation among a Chinese population.

Methods: Participants were recruited from six primary health care centers. A total of 144 were eligible to take part in the study and agreed to be randomized to the intervention (ACT) group (n = 70) and control group (n = 74), respectively. Both groups received self-help materials on smoking cessation. The ACT group also underwent an initial face-to-face session and two telephone ACT sessions at 1 week and 1 month following the first session. They were re-contacted through telephone follow-ups at 3, 6, and 12 months by research assistants. The primary outcome was self-reported 7-day point-prevalence abstinence at the 12-month follow-up session. Other outcomes included biochemically validated quitting, quitting attempts, the intention to quit, the self-perception of quitting, and psychological flexibility.

Results: There was no significant difference in the self-reported 7-day point prevalence quit rate at the 12-month follow-up between the intervention group (24.3%) and the control group (21.6%) (risk ratio = 1.12; 95%CI = (0.62, 2.05); p = 0.704). Greater improvements in secondary outcomes from baseline to the 12-month follow-up were observed in the ACT group than in the control group, including a forward progression in the participants' readiness to quit smoking (p = 0.014) and increased psychological flexibility (p = 0.022).

Conclusions: This study is the first evidence of a randomized-controlled trial on the adoption of an individual ACT for smoking cessation, delivered initially in primary health care settings and subsequently by telephone within a Chinese population. The present study found that the brief ACT intervention could not produce a significant quit rate but was promising in terms of bringing about cognitive changes, including greater psychological flexibility, and more confidence about quitting, when compared to the use of self-help materials only among the general population.

Trial registration: This trial was registered prospectively with the U.S. National Library of Medicine: ( NCT01652508 ) on 26th July 2012.

Keywords: Acceptance and commitment therapy (ACT); Face-to-face; Primary health care; Randomized controlled trial (RCT); Smoking cessation program; Telephone.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow of participants through the phases of the RCT

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