Economic Evaluation And Factors Affecting Smoking Cessation Using Istop Program In A Local Manufacturing Company

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Date
2018-08
Authors
Goh, Su Lun
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Publisher
Universiti Sains Malaysia
Abstract
Tobacco products are a double-edged sword. While tobacco products contribute to a country’s economic significantly, it is also a notable risk factor for human health and a silent thief of the wealth of its users, society and nation. Apart from the healthcare cost, the work performance of smokers is also being affected leading to lower productivity. Many studies have also shown that workplace smoking cessation programs are effective and have generated positive savings for the employers. Therefore, workplace smoking cessation has been viewed as a potential strategy to combat the usage of tobacco products. Abundant studies have been carried out abroad, but local studies are scares; especially in the private manufacturing sector. This study was a cross-sectional single prospective cohort workplace smoking cessation study conducted in a local manufacturing company. This study reviewed a 12-week innovative multi-component smoking cessation intervention program to support smoking employees to quit smoking, called “iSTOP” program. The objectives of this study were to evaluate the effectiveness of this innovative program and the smokers’ behaviours as well as to identify factors affecting smoking cessation and relapse. On top of these, the quality of this program was also evaluated using qualitative analysis method, making it more effective in assisting smokers to quit smoking. As this was the Company fully sponsored program, the last section was to calculate the economic return this program to the employer using the common commercial indicators (ROI and IRR), which are familiar by the Management team. This study was also the first study prescribing varenicline and the combination of varenicline with nicotine replacement therapy (NRT) in a workplace setting. The results of this study were very encouraging. A total of 155 participants took part, and they were divided into two batches to go through the iSTOP program. The overall short-term and long-term abstinent rates were 45.8% and 37.4% respectively. The multivariate analysis concluded that the factors affecting abstinence for one year were the level of adherence to the clinical intervention program and having a strong perception of the effect of smoking on health. Factors related to relapse were staying in the urban area, previous quit attempt of less than 1 week and not receiving GP’s advice in the current year. All the interviewed participants valued the effort put on by the Company for this free-ofcharge program. Use of varenicline and its combination with NRT were well-accepted by the participants. Self-willingness, self-efficacy and self-motivation with continuous support and motivation from the surroundings were critical factors in successful smoking cessation. This lead to the development of “CARE” model for workplace smoking cessation program. The ROI over 5 years and IRR per year of this program were 156% and 20.7% respectively, confirming that iSTOP program was a promising investment project for the Management. In conclusion, this thesis confirmed that iSTOP program was effective and benefited the employers. Future actions were to apply the “CARE” model in a workplace smoking cessation program to further enhance its effectiveness.
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Pharmacological
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