1. THE EFFECTIVENESS OF GROUP COUNSELING MODULE IN SMOKING CESSATION PROGRAM : QUANTITATIVE AND QUALITATIVE APPROACHES Rohani Ismail 1 , Syed Aljunid 2 , Khalib Abd Latip1,Wan Sharifa Ezat Wan Puteh 1 1 Department of Community Health, Faculty of Medicine Universiti Kebangsaan Malaysia 2 United Nations University-International Institute For Global Health, Kuala Lumpur Malaysia 3 RD MCTC CONFERENCE 8-9 AUGUST 2009

10. Measure of knowledge and attitude (4 month after intervention) Measure knowledge and attitude 4 month post baseline Measure knowledge and attitude - 8 month post baseline. Final follow up Measure knowledge and attitude – 8 month without intervention ( 12 month post baseline) Final follow up Measure knowledge and attitude – 12 month post baseline Measure knowledge and attitude - 4 month without intervention. (8 month post baseline) 4 month intervention 4 month 4 month MODULE DEVELOPMENT BY RESEARCH TEAM and PRE TESTED SCREENING PROCESS (smoking at least one day past 30 days an intention to stop at contemplation, preparation and action stage ) (N = 346) INTERVENTION GROUP (n=158) NON INTERVENTION GROUP (n = 188) Measure of quit rate (8 moths post baseline) Measure of quit rate (4 moths post baseline) PHASE 1 PHASE 2 PHASE 3 Program evaluation (in depth interview among counselors) STUDY FLOW Measure of quit rate (12 moths post baseline) Group counseling intervention Usual practice

12. SMOKING CESSATION PACKAGE

13. 1 2 3 4 5 6 7 8 9* 10 11 12 13 14 15* 16 17 18 19 20 21 22 23 *24 1 st session = Iice breaking (4 h) 2 nd session = Brain storming (4 h) 3 rd session = Decision making (2 h) 4 th session = Decision making (2 h) 5 th session = Decision making ( 2 h) 1 st ses. 2 nd ses. 3 rd & 4 th ses. 5 th ses. 7 th ses. 8 th ses. 9 th ses. 10 th ses. 6 th session = Managing withdrawal symptom 1 (4 h) session = Managing withdrawal symptom 2 (2 h) 8 th session = Managing daily activities (2 h) 9 th session = Reflection Activities (2 h) 10 th session = Outdoor activities (3 days 2 nights) COUNSELLING SESSION WEEK 1 st MODULE = PREPARATION TO STOP SMOKING (1 st ,2 nd session) 2 nd MODULE = DECISION MAKING (3 rd ,4 th ,5 th session) 3 rd MODULE = MANAGING WITHDRAWAL SYMPTOM (6 th ,7 th session) 4 th MODULE = REMAINING CESSATION STATUS ( 8 th ,9 th ,10 th session) 6 th ses. JULY 2005 OCTOBER 2005

15. Figure 1 : Respondents d istribution by gender (n= 346)

16. Figure 2 : Respondents d istribution by ethnics (n= 346)

17. Figure 3 : Initiation age of start smoking

18. Figure 4 : Stage of changes quitting smoking

19. Figure 5 : Number of cigarettes

20. Figure 6 : Number of smoking day

21. Table 1 : Baseline characteristic of study group PARAMETER IG (n= 158) NIG (n= 188) P value Male Female 143 (90.5) 15 ( 9.5) 158 (84.0) 30 (16.0) 0.075 Malay Chinese India 153 (96.8) 2 (1.3) 3 (1.9) 179 (95.2) 3 (1.5) 6 (3.2) 0.425 Initiation age of smoking < 7-9 years 10-11 years 12-13 years 14 years 12 (7.6) 25 (15.8) 91 (57.6) 30 (19.0) 19 (10.2) 34 (18.2) 87 (46.5) 47 (25.1) 0.222

22. PARAMETER IG (n= 158) NIG (n= 188) P value Number of cigarettes 1 stick 2-5 sticks >6 sticks 80 (50.6) 63 (39.9) 15 ( 9.5) 114 (61.0) 59 (31.6) 14 (7.5) 0.156 Number of days smoking 1-5 days 6-19 days 20-30 days 53 (38.1) 55 (39.6) 31 (22.3) 83 (52.5) 55 (34.6) 21 (13.2) 0.027

23. PARAMETER IG (n= 158) NIG (n= 188) P value Stage of changes Contemplation Preparation Action 66 (41.8) 37 (23.4) 55 (34.8) 73 (38.8) 49 (26.1) 66 (35.1) 0.807 Fagerstrom Scale Less addicted Moderate addicted High addicted 138 (87.3) 18 (11.4) 2 (1.3) 161 (85.6) 21 (11.2) 6 (3.2) 0.494

24. Table 4 : Smoking quit rate among intervention and non intervention group * P < 0.005 Intervention (n = 158) Non intervention (n = 188) Chi square test 4 months post baseline 71 (44.9) 60 (31.9) 6.19 (0.01)* 8 months post baseline 33 (20.9) 45 (23.9) 0.46 (0.50) 12 months post baseline 29 (18.4) 49 (26.1) 2.92 (0.09)

25. Table 5 : Predictors on quit smoking Factors Wald Adjusted odds ratio 95% CI P value Sex Male Female 7.54 2.67 1.32 – 5.36 0.006* Received counseling Yes No 6.49 2.00 1.17 – 3.40 0.01* Intention to stop smoking Action Contemplation 8.31 2.36 1.31 – 4.24 0.00* Parent smoking Yes No 4.31 1.68 1.03 – 2.74 0.04*

34. ACTIVITIES AT SCHOOL