{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:55:54Z","timestamp":1791384954329,"version":"4.3.3"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Smoking rates are disproportionately high among people with mental health issues. We evaluated the effectiveness of a chat\u2010based intervention paired with psychological support for workplace smokers with mental health symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A pragmatic, two\u2010arm, randomized controlled trial in 65 companies in Hong Kong, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>300 employees who smoked daily (84.3% male) with stress (Perceived Stress Scale\u20104\u2009\u2265\u20096), anxiety (General Anxiety Disorder\u20102\u2009\u2265\u20093) or depressive symptoms (Patient Health Questionnaire\u20102\u2009\u2265\u20093).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were randomly allocated to either the intervention group (<jats:italic>n<\/jats:italic>\u2009=\u2009144) or the control group (<jats:italic>n<\/jats:italic>\u2009=\u2009156). The intervention group received 20 instant messages and chat\u2010based support delivered by trained counselors over 3\u00a0months, using Acceptance and Commitment Therapy. The control group received 6 messages on general health. Both groups received a health talk and self\u2010help booklet at baseline, brief phone advice at follow\u2010ups and full\u2010course nicotine replacement therapy for continuing smokers at 6\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The primary outcome was self\u2010reported 7\u2010day point prevalence abstinence (PPA) at 6\u00a0months after intervention initiation. Secondary outcomes included PPA at 1, 3, 9 and 12\u2009months, changes in mental health symptoms and intervention engagement (chatting with counsellors).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>By intention to treat, there was no evidence of a difference in 7\u2010day PPA between intervention and control group at 6\u00a0months [16.0% vs. 13.5%, odds ratio (OR)\u2009=\u20091.22, 95% confidence interval (CI) = 0.64\u20132.32]. At 12\u2009months, there was weak evidence of an intervention benefit (21.5% vs. 13.5%, 1.76, 0.96\u20133.24), which was statistically significant after adjusting for baseline factors (adjusted OR\u2009=\u20092.61, 1.22\u20135.58, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). A greater reduction in anxiety symptoms over a 12\u2010month period in the intervention group was observed (adjusted <jats:italic>b<\/jats:italic>\u2009=\u2009\u22120.28, 95% CI = \u22120.56 to \u22120.00, <jats:italic>P<\/jats:italic>\u2009=\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There appears to be weak evidence for a benefit of a personalised chat\u2010based smoking cessation intervention plus psychological support on promoting smoking abstinence among workplace smokers with mental health symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70013","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T07:48:08Z","timestamp":1739260088000},"page":"1390-1401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Personalized chat\u2010based support for smoking cessation among smokers with mental health symptoms in the workplace: A randomized controlled trial"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7619-3898","authenticated-orcid":false,"given":"Ying","family":"Yao","sequence":"first","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu Tsun","family":"Luk","sequence":"additional","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"},{"name":"Alice Lee Centre of Nursing Studies National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oi Sze","family":"Lau","sequence":"additional","affiliation":[{"name":"The Lok Sin Tong Benevolent Society Kowloon  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongda Socrates","family":"Wu","sequence":"additional","affiliation":[{"name":"Children's Hospital of Eastern Ontario Research Institute  Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Weng","sequence":"additional","affiliation":[{"name":"Institute of Advanced Studies in Humanities and Social Science Beijing Normal University  Zhuhai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chak Hang","family":"Ng","sequence":"additional","affiliation":[{"name":"The Lok Sin Tong Benevolent Society Kowloon  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5850-5349","authenticated-orcid":false,"given":"Yee Tak Derek","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai Hing","family":"Lam","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University 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