Effectiveness of training stop‐smoking advisers to deliver cessation support to the UK national proposed standard versus usual care in Malaysia: a two‐arm cluster‐randomized controlled trial

Aims To assess the effectiveness of training stop smoking services providers in Malaysia to deliver support for cessation based on UK National Centre Smoking Cessation and Training (NCSCT) standard treatment programme compared with usual care. Design Two-arm cluster-randomized controlled trial across 19 sites follow-up at 4-week, 3-month, 6-month. Setting Stop operating public hospitals Malaysia. Participants Five hundred two smokers [mean ± deviation (SD), age 45.6 (13.4) years; 97.4% male] attending hospital settings Malaysia: 330 10 intervention condition 172 nine control condition. Intervention comparator The consisted stop-smoking practitioners according NCSCT Standard Treatment Programme. was care (brief follow-up). Measurements primary outcome continuous tobacco abstinence up 6 months who received treatment, verified by expired-air carbon monoxide (CO) concentration. Secondary outcomes were CO-verified 4 weeks 3 months. Results Follow-up rates weeks, 80.0, 70.6 53.3%, respectively, group 48.8, 30.8 23.3%, group. At 6-month follow-up, 93 participants abstinent from smoking, representing 28.2 versus 11.0% an intention-to-treat (ITT) analysis assuming that missing data had resumed 52.8 47.5% a follow-up-only (FUO) analysis. Unadjusted odds ratios (accounting clustering) 5.04, (95% confidence interval (CI) = 1.22–20.77, P 0.025) 1.70, CI 0.25–11.53, 0.589) ITT FUO analyses, respectively. Abstinence week month follow-ups significantly higher but not Conclusions On missing-equals-smoking imputation, Malaysian service appeared increase seeking help stopping However, effect may have been due increasing rates.