Effect of a Personalized Cardiovascular Risk Score Report on Employee Smoking Behavior in a Private Hospital

Abstract

Smoking is a major cause of non-communicable diseases. The World Health Organization identified that 10% of cardiovascular diseases are attributable to smoking. Thailand 2019 statistics indicated that cardiovascular disease was the second leading cause of death in the Thai population. The death rate associated with cardiovascular disease was 33.90 per 100,000 population. In other words, not smoking is the best way to reduce the risk of developing heart disease and, in those who experience coronary heart disease, stopping smoking reduces the incidence of recurrence and death. Smoking cessation has been one of the Thai national strategies for tobacco control to decrease smoking prevalence since the last decade. Employee health is a crucial factor for organizational effectiveness. To promote employee health, the hospital that was the setting for this study provides a health checkup for their employees once a year. This conventional checkup report is sent to each employee. Previous studies have shown a correlation between the use of the cardiovascular risk score report and mortality and morbidity. However, there is no evidence of using the cardiovascular risk score report to motivate individuals to stop smoking. This research aimed to compare the effect of a personalized cardiovascular risk score report on employee smoking behavior in a private hospital located in the Bangkok Metropolitan Area. The study was a randomized controlled trial. The experimental and comparison groups consisted of 36 current smokers who were employed full-time at the hospital, and who voluntarily participated in this study. The participants were randomly divided into three groups. Group 1 received the modified cardiovascular risk score, true cardiovascular risk score, and conventional checkup report. Group 2 received the true cardiovascular risk score and conventional checkup report. Group 3 received the conventional checkup report. The participants in each group received the allotted intervention during week 0, 4, 8 and 12. Data were collected using a questionnaire from January to April 2020. We used descriptive statistics, Fisher’s Exact test, one-way ANOVA, repeated-measures ANOVA, GEE, Unpaired t-test, and McNemar Chi Square for data analysis. The mean ± SD age of the participants was 35.66 ± 10.54 years. 97.2% were males, 33.3% of them had graduated with a bachelor’s degree, and 55.6% had non-clinical indirect-care positions. Their average income was 25,341.18 ± 15,465.90 Baht per month. 72.2% of the participants were not addicted to nicotine. 66.7% had a low level of cardiovascular risk. Before the experiments were performed, the participants smoked 53.03 ± 47.88 cigarettes per week and 66.7% of the participants had no intention to quit smoking. There was no significant difference among the three groups at baseline (week 0). The results showed that different types of cardiovascular risk score report had no effect on smoking behavior (p = 0.91). In addition, cardiovascular risk score report had no effect on the intention to quit smoking in the intervention group. However, the number of cigarettes smoked per week in the intervention groups significantly decreased when compared to the comparison group (p < 0.05).