Effect of a group tobacco cessation behavioral intervention among patients with mental illness in Kenya: Results from a controlled clinical trial

Autor: Yvonne Olando, Muthoni Mathai, Mary W. Kuria, Francis Njiri, Mark D. Huffman
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Population Medicine, Vol 4, Iss August, Pp 1-10 (2022)
Druh dokumentu: article
ISSN: 2654-1459
DOI: 10.18332/popmed/152132
Popis: Introduction Individuals with mental disorders are more susceptible to initiating and sustaining tobacco use; unfortunately, most do not get support to quit. Group behavioral counselling, an effective low-cost strategy for cessation has been shown to be effective, yet has not been studied among this population in Kenya. Methods Mentally ill tobacco users at Mathari Referral and Teaching Hospital’s Clinic for Substance Abuse Treatment in Nairobi, were recruited from September 2017 to March 2019. Participants were allocated into intervention and control groups (1:1). Intervention group participants met in groups of 10 over a 24-week period to participate in group behavioral counselling sessions using a structured curriculum to promote cessation. Control group participants received usual care. The primary outcome was tobacco cessation at 24 weeks measured through salivary cotinine strips. Secondary outcomes included self-reported number of cigarettes/sticks used daily and health-related quality of life (HRQOL), using the WHOQOL Brief Questionnaire at 24 weeks. Between-group event rates were compared using Cox proportional hazards models, while differences in HRQOL scores were analyzed using paired t-tests. Results Participants’ mean age was 35 (SD=9) years, 87% were male, and 42% had completed secondary education. Over half (65%) had substance use disorders (diagnosed) and 15% had major depressive disorders. Most participants (94%) used cigarettes at baseline and participants smoked for a mean of 13 (SD=11) years with an average of 14 (SD=7) sticks daily. Intervention group participants reported a higher cessation rate (15.2% vs 0%, p=0.02 at week 12, and 9.1% vs 0%, p=0.10 at week 24), with a lower number of sticks smoked (97% vs 58.6%, p
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