Community-Based Tobacco Smoking Cessation Programmes Among Adolescents in Sarawak: Lesson Learned from Process Evaluation

Abstract Introduction: This study evaluated the effectiveness of community-based quit-smoking interventions using the 5A’s and 3A’s modules. Methods: The study was conducted between 2020 and 2021 in Samarahan and Asajaya District, Sarawak, Malaysia. The study included 519 participants out of 600 individuals, and both facilitators and observers evaluated the process. The process evaluation assessed various components: fidelity, dose delivered, dose received, reach, satisfaction, context, justification for intervention withdrawal, facilitator influence on sessions, and intervention feedback. Results: The study found that most facilitators executed more than 85% of both session modules, achieving at least 75% of the objectives. Most participants of both sessions were positively and actively engaged and would recommend intervention to others. The participants reported positive feedback. However, 26.3% of participants withdrew from the second session due to inconvenient timing. The observer’s fidelity evaluations of both intervention sessions were fully implemented according to plans, achieving over 75% of their objectives. Observers acknowledged active and engaged participants during both intervention sessions and regarded all facilitators as appropriate and positive toward participants. The process evaluation showed that the interventions were administered well, and smoking adolescents demonstrated a willingness to quit smoking due to the outcomes of this intervention. Conclusion: The findings of this study provide valuable insights into the effectiveness of community-based interventions for quitting smoking and highlight the importance of evaluating the process of interventions to understand their relationship with outcomes. The study’s results can inform the development and implementation of future interventions to reduce smoking incidence among adolescents.