INTRODUCTION: Smoking prevalence is high in Viet Nam, yet tobacco dependence treatment (TDT) is not widely available.
METHODS: We conducted a quasi-experimental study that compared the effectiveness of health care provider advice and assistance (ARM 1) vs. ARM 1 plus village health worker (VHW) counseling (ARM 2) on abstinence at 6-month follow-up. This study was embedded in a larger two-arm cluster randomized controlled trial (RCT) conducted in 26 community health centers (CHCs) in Viet Nam. Subjects (N=1,318) were adult patients who visited any participating CHC during the parent RCT intervention period and were self-identified as current tobacco users (cigarettes and/or waterpipe).
RESULTS: At 6-month follow-up, abstinences rates in ARM 2 were significantly higher than ARM 1 (25.7% vs. 10.5%; p<.001). In multivariate analyses smokers in ARM 2 were almost three times more likely to quit compared with those in ARM 1 (adjusted odds ratio [AOR]=2.96, 95% confidence interval [CI]=1.78-4.92). Compared to cigarette-only smokers, waterpipe-only smokers (AOR=0.4, 95% CI=0.26-0.62) and dual users (AOR=0.62, 95% CI=0.45-0.86) were less likely to achieve abstinence, however the addition of VHW counseling (ARM 2) was associated with higher quit rates compared with ARM 1 alone for all smoker types.
CONCLUSION: A team approach in TDT programs that offers a referral system for health care providers to refer smokers to VHW-led cessation counseling is a promising and potentially scalable model for increasing access to evidence-based TDT and increasing quit rates in LMICs. TDT programs may need to adapt interventions to improve outcomes for waterpipe users.
Effectiveness of village health worker delivered smoking cessation counseling in Viet Nam
Nicotine and Tobacco Research, 21 (11), 1524-1530. doi: 10.1093/ntr/nty216. PMCID: PMC6941703.