EFFECTS OF COMPULSORY VERSUS VOLUNTARY METHODS FOR YOUTH OFFENDERS IN A PHARMACIST-BASED SMOKING CESSATION PROGRAM
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Abstract
The purpose of this quasi-experimental trial was to compare the effectiveness of a pharmacist-based smoking cessation program for youth offenders between a compulsory and a voluntary method and to determine the predictors of cigarette smoking in youth offenders. The study was conducted at the Juvenile Family Division, Pathumtani Provincial Court, in Thailand. A total of 182 youth offenders who smoked cigarettes regularly in the past six months were enrolled in the study. Participants were assigned to one of the two groups at the judge’s discretion. Youth offenders in the study group were ordered to stop smoking by a compulsory method, while those in the control group were advised to stop smoking by a voluntary method. Both groups were included in a pharmacist-based smoking cessation program at the Thanyarak Hospital. The primary outcomes were continuous abstinence rate and 7-day point prevalence abstinence rate at 24 weeks after the quit date, which were confirmed by urine cotinine test. The 7-day point prevalence abstinence rates were significantly higher for the compulsory method compared to the voluntary method at week 16 (28.9% versus 15.2%, p=0.026) through week 24 (35.6% versus 15.2%, p=0.002). Continuous abstinence rates throughout the 24 weeks were not significantly different between the two methods. The number of cigarettes smoked per week in compulsory group was significantly lower than that of the voluntary group at all visits (p<0.001). The number of “smokers in friends’ group”, “age started smoking”, and “educational level at senior high school” were significant predictors of cigarette smoking (R2=0.24, p=0.021). A pharmacist-based smoking cessation program with a compulsory method had more success in helping youth offenders to quit smoking, change their stage of readiness to quit, and decrease the number of cigarettes smoked per week.
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