Promoting smoking cessation in Bangladeshi and Pakistani male adults: pilot randomised controlled trial

The countries of the UK have committed themselves to reducing the prevalence of smoking, as it is the single largest preventable cause of morbidity and mortality. Many of the smokers of the UK are committed to this goal also; nearly one third try to stop each year. To assist smokers in their efforts, we have a national network of stop smoking services and make medication available on the NHS. However, most people who attempt to stop do not use the services, and people from Pakistani and Bangladeshi groups are particularly unlikely to do so. This is important because the services are effective, and without their support, very few of the more dependent smokers will succeed. Our proposal aims to develop service configurations that better meet the needs of smokers from these two ethnic groups. Thus we are proposing to offer better services to thousands of particularly disadvantage UK citizens for which their is a manifest need and Government commitment to meeting that need, yet currently manifest failure to do so.

Background: Bangladeshis and Pakistanis are two of the most deprived and marginalised communities in Britain, with persistent poor health outcomes for a range of chronic disorders. Tobacco use is particularly high amongst males. Bangladeshi and Pakistani smokers are poorly served by current primary care and specialist smoking cessation services; existing service formulations need adaptation to better meet their needs.

Objectives: In relation to Bangladeshi and Pakistani adult male smokers, we aim to refine and pilot two models (operating within smoking cessation clinics; and operating within clinics + additional community outreach work) of using trained community smoking cessation workers to improve reach of, access to and success of NHS smoking cessation services.

Methods: Pilot cluster randomised controlled trial based in Birmingham comparing the effectiveness of these interventions with standard care.

Outcomes: Our outcome measures of interest include the proportion of smokers that attempt to quit using the stop smoking service as a proportion of all those in intervention and control areas that attempt to stop smoking in the same period, the acceptability of the interventions offered, concordance, design effect and short- (4 weeks) and medium-term (3 and 6 month) quit rates with a view to conducting a definitive trial. In addition, we will assess the impact of these interventions on concomitant short- and medium-term smokeless (oral) tobacco use.