Predictors of participation in a telephone-based Acceptance and Commitment Therapy for smoking cessation study

Abstract

Background: Little is known about factors that influence participation in smoking cessation trials among Chinese populations. The aim of this study is to explore the characteristics of individuals who chose to participate and those who chose not to participate in a proactive telephone-based acceptance and commitment therapy program for smoking cessation within a Chinese sample, and to identify predictors of program participation. Understanding the factors that predict participation in smoking cessation trials may allow researchers and healthcare professionals to target their recruitment efforts to increase the enrollment of smokers in smoking cessation programs. Methods: Participants were proactively recruited from six primary healthcare centers. Current cigarette smokers were screened for eligibility and then invited to complete a baseline questionnaire for the trial. The differences in characteristics between participants and non-participants as well as factors predictive of participation were analyzed using Chi-square tests and logistics regression. Results: A total of 30,784 clinic attendees were approached. From these, 3,890 (12.6 %) smokers were screened and identified. Of the 3,890 smokers, 420 (10.8 %) were eligible to participate and completed the baseline questionnaires. The analysis showed that participants (n = 142) and non-participants (n = 278) differed significantly in terms of demographics, smoking-related, and psychological variables. The following characteristics were found to predict program participation: those with a relatively high level of dependence on nicotine (OR = 3.75; 95 % CI = 1.25-11.23), those in the contemplation (OR = 7.86; 95 % CI = 2.90-21.30) or preparation (OR = 24.81; 95 % CI = 8.93-68.96) stages of change, and those who had abstained for one month or less in a previous attempt at quitting (OR = 3.77; 95 % CI = 1.68-8.47). Conclusions: The study shed light on the factors predictive of participation in a counseling-based smoking cessation program among a Chinese population. The results were encouraging, as most significant predictors (e.g., nicotine dependence, stage of change in smoking cessation) can be feasibly addressed or modified with interventions. No significant predictive relationships were found between psycho-social variables or socio-demographic variables and participation. Efforts should be made to increase the enrollment of smokers who are seemingly not yet ready to quit, and to tailor the program to fit the program's participants.