# The outcomes of hybrid virtual consultation for a smoking cessation program in Klang Valley, Malaysia

## TL;DR

A study in Malaysia found that a hybrid virtual consultation model for smoking cessation was more effective and had better outcomes than traditional face-to-face methods.

## Contribution

The study demonstrates that hybrid virtual consultations improve smoking cessation outcomes compared to in-person sessions.

## Key findings

- Hybrid virtual consultation had a higher point abstinence rate at week 7 (56.1%) compared to face-to-face.
- The hybrid group maintained a 56.1% continuous abstinence rate from week 7 to 24.
- Hybrid consultations had lower defaulter rates and higher program completion rates.

## Abstract

Smoking has become a leading preventable cause of premature death and morbidity worldwide, with 8 million people dying each year because of tobacco. In Malaysia, a 24-week standard smoking cessation program is available to help smokers. Teleconsultation was introduced into this program during the COVID-19 pandemic by using internet-based video counseling to reduce the number of clinic visits. This study aimed to evaluate the outcomes of hybrid virtual consultation for smoking cessation programs among patients with nicotine dependence.

A retrospective cross-sectional study was conducted where all the active smokers registered in the smoking cessation program from 2018 to 2023 were recruited. They were grouped into face-to-face interventions and hybrid virtual consultations. All data were obtained from the smoking cessation program registry. The primary outcome was point abstinence (PA) at week 7 (1-month post-quit date), biochemically verified with carbon monoxide (CO) Smokerlyzer for both face-to-face and hybrid groups.

A total of 156 participants were included in this study, including face-to-face (99 participants) and hybrid virtual consultation (57 participants). The mean age of face-to-face and hybrid group participants was 51 and 48 years, respectively. In general, hybrid virtual consultation was more feasible, as evidenced by a lower defaulter rate and a higher rate of participants graduating at the end of the program than face-to-face consultation. The effectiveness of smoking cessation was also higher in hybrid consultation, with a higher abstinence rate at weeks 4 and 7, with percentages of 42.1% and 56.1%, respectively. Additionally, the hybrid group maintained a high continuous abstinence rate (CAR) from week 7 to 24, with a percentage of 56.1%.

Hybrid virtual consultation was more effective, as evidenced by higher smoking cessation at week 7 (1-month post-quit date) and CAR from week 7 to week 24 compared to the face-to-face group. Telemedicine or teleconsultation should be easily available for smoking cessation programs, and healthcare providers should consider incorporating hybrid models into them to fully utilize the program and improve outcomes.