Reaching Youth Smokers Through a Multipronged Approach: Comparison of Three Recruitment Methods of a Youth Quitline in Hong Kong

Purpose: Using multipronged recruitment strategies is crucial for reaching diverse smokers, yet research specifically focusing on youths is lacking. This prospective study compared the characteristics and abstinence outcomes of youth smokers enrolled in a youth-centered cessation service by three different methods.

Methods: From December 2016 to February 2022, the Youth Quitline enrolled 1,197 smokers aged 10-25 (mean = 19.4) years through traditional method (incoming calls or referrals, n = 276), proactive outreach (n = 735), and online method (website or social media platforms, n = 186). Logistic regression was used to calculate the odds ratio (OR) of biochemically validated tobacco abstinence at 6 months by recruitment methods.

Results: Proportionally more participants recruited via online method than traditional method and outreach had moderate to heavy nicotine dependence (53.2% vs. 40.9% vs. 27.6%, p < .001), poor self-rated health (27.6% vs. 21.9% vs. 12.3%, p < .001), and risk of depression (51.4% vs. 42.5% vs. 37.4%, p = .003). More participants recruited by outreach (71.6%) had no intention to quit in 30 days than traditional (58.3%) and online (59.7%) methods (p < .001). Compared with traditional method, the 6-month validated abstinence rate was similar in smokers recruited by online method (crude OR 0.77, 95% confidence interval 0.44-1.34) but significantly lower in those recruited by outreach (crude OR 0.44, 95% confidence interval 0.28-0.67). Results were similar after adjusting for sociodemographic and baseline predictors of abstinence.

Discussion: Online recruitment can attract youth smokers with greater nicotine dependence and poorer health, whereas outreach can engage those with less motivation to quit. The lower quit rate in outreach-recruited participants indicated the need for more effective interventions.