Successful Smoking Cessation after Foot Reflexology
Keywords:Foot reflexology, predictability, successful smoking cessation, Foot reflexology, Predictability, Successful smoking cessation
Foot reflexology is a traditional Chinese medicine that is used for facilitating smoking cessation. Foot reflexology for smoking cessation is easy to learn and do, as well as being safe and cost-effective. However, it is not commonly used in cessation clinics in health care centers, compared with other methods, because there are few studies that verify its effectiveness. More studies about the effect of foot reflexology on smoking cessation are needed. Therefore, the purpose of this experimental evaluation research (single-group trial) was to study the effect of foot reflexology on the smoking cessation behavior of daily smokers and predictors of successful smoking cessation with foot reflexology.
The study was conducted in Ratchaburi Province, Thailand. The province was divided into two zones, and the researchers randomized one district from each zone. One subdistrict health promoting hospital (SHPH) was randomized, with a sample size of 120 smokers from each SHPH, so that the total number of subjects was 240. The study volunteers were given brief advice with 2As (Ask and Advice) regarding smoking cessation, followed by foot reflexology for around 20 minutes for 10 consecutive days. Data were collected using interviews and a record form at a pre- and post-massage date from day 2 to day 10. The study volunteers were followed up at 30, 90 and 180 days to measure continuous abstinence rate (CAR). Data were analyzed by descriptive and analytical statistics including Chi-square, one-way ANOVA, and binary logistic regression.
The results of foot reflexology showed that CAR increased steadily over 10 days of massage, from 4.1% at day 2 to 29.2% at day 10 and gradually decreased to 28.8%, 25.6%, and 26.7% at one, three, and six months. The study of factors associated with smoking cessation was achieved by using bi-variate analysis. There were four factors that were statistically significant. The first one was age of smokers; CAR of the smokers aged 60 years and over was 41.5%, which was higher than the smokers aged <24 years (27.8%) and 25-59 years (20.4%) (p = 0.004). The second one was the daily number of cigarettes smoked; the CAR of smokers who smoked 1-9 cigarettes/d was 48.6%, which was higher than those who smoked 10-19 cigarettes/d (26.0%) and >20 cigarettes/d (21.1%) (p<0.001). The third one was nicotine dependence level; the CAR of the smokers who had a low and moderate level of nicotine dependence were 32.6% and 32.4%, in contrast with 19.4% in those who had a high level of nicotine dependence (p = 0.009). The fourth one was intention to quit smoking; the CAR of smokers who intended to quit smoking within 7 days and 30 days were 31.4% and 33.3% compared with 13.3% in those who intended to quit within 6 months or more and 13.2% in those who did not intend to quit (p = 0.032). These 4 factors were able to explain the variability of CAR (26.9%).
The results of this research confirm that foot reflexology is an effective way to facilitate smoking cessation. Therefore, the Ministry of Public Health should promote the use of foot reflexology in public health facilities. Training for traditional Thai medicine personel, at all levels, should be organized in order to provide knowledge and skills in foot reflexology for smoking cessation, and expand its application.
Siamrath Newspapers. Fahsai Clinic helps Thai people quit smoking: Build a proactive smoking cessation network. Available from http://www.thaihealth.or.th/Content/17466- Fahsai Clinic helps Thai people quit smoking.html, accessed 10 December, 2019. (In Thai)
Krittiyapichartkul C. Situation and trends of tobacco consumption in Thailand. Presentation for tobacco control leadership training; 2016. (In Thai)
Rungrojsakulporn S. Lecture Title: Foot reflexology. December 10, 2005, 10.00-12.00 am. Benjakul Room, Institute of Thai Traditional Medicine, Department of Thai Traditional Development, Alternative Medicine Division, Ministry of Public Health; 2005. (In Thai)
Vimuktalop P. The effect of foot reflexology on stress and blood pressure in essential hypertensive patients. [M.N.S. Thesis in Adult Nursing] Nakornpathom: Faculty of Graduate Studies, Mahidol University; 2008. (In Thai)
Jongsomjit P. The effect of foot reflexology on physiological responses, relaxation and satisfaction in those with high blood pressure. [M.N.S. Thesis in Community Health Nursing]. Nakornpathom: Faculty of Graduate Studies, Mahidol University; 2008. (In Thai)
Nuchan S, Rattanathongkom S. The effect of Thai massage and acupressure on foot numbness in patients, with diabetic mellitus: A study at Pon Swang primary care unit, Tambon Jorakae, Amphure Nongruea, Khon Kaen Province. Journal of Medical Technology and Physical Therapy 2018; 20(2): 139-47. (In Thai)
Yodkaew U, Petpichetchian W, Chongchareon W. Reﬂexology and its impact on cancer patients’ perception of pain and suffering from the perception of pain. Thai Journal of Nursing Council 2016; 31(4): 5-19. (In Thai)
Sakdanuphab Y, Ounprasertpong NL, Piaseu N. Effects of Thai massage and foot reflexology on blood sugar and sensory loss on the foot in type 2 diabetes patients. Journal of Health Education 2010; 33(114): 44-54. (In Thai)
Yodsirajinda S. Effects of foot reflexology combined with medication on blood sugar and sensory loss on the foot in older adults with type 2 diabetes. Journal of Allied Health Sciences Suan Sunandha Rajabhat University 2017; 2(1): 15-33. (In Thai)
Nuansate K, Ounprasertpong-Nicharojana L, Piaseu N. Secondary data analysis: Effects of behavioral modification program and foot reflexology integrated with medication use on blood sugar, hemoglobin A1C and numbness in persons with type 2 diabetes mellitus. Kuakarun Journal of Nursing 2016; 22(1): 156-73. (In Thai)
Chitra J, Smriti A, Lama TE. A study to assess the effectiveness of foot massage on pain among patients after abdominal surgery in a selected hospital of Delhi. International Journal of Nursing Education 2014; 6 (2): 112-6. (In Thai)
Jeong IS. Effect of self-foot reflexology on peripheral blood circulation and peripheral neuropathy in patients with diabetes mellitus. Journal of Korean Academy of Fundamentals of Nursing 2006; 13(2): 225-34.
Ramos DG, Alimboyao SV, Dompiles AD, Nazarro EG, Pascua NM, Pawid KJ, et al. The effect of Kolkolis in reducing blood pressure. Int J Nephrol Kidney Failure 2015; 1(3): doi http://dx.doi. org/10.16966/2380-5498.112
Toomey B. Type 2 diabetes and reflexology. Available from https://academyofancientreflexology.com/wp-content/uploads/2015/05/Type_2_Diabetes_case_study.pdf, accessed 7 December, 2016.
Nakano H, Kodama T, Ueda T, Mori I, Tani T, Murata S. Effect of hand and foot massage therapy on psychological factors and EEG activity in elderly people requiring long-term care: A randomized crossover study. Brain Sci 2019; 9(3): 54.
Nakamaru T, Miura N, Fukushima A, Kawashima R. Somatotopical relationships between cortical activity and reflex areas in reflexology: A functional magnetic resonance imaging study. Neurosci Lett 2008; 448(1): 6–9.
Krobthong A, Dolampornphisuts T, Teerasiriroj T. A randomized controlled trial of foot reflexolgy in treatment of tobacco addiction: Pilot study. Journal of Thai Traditional and Alternative Medicine 2015; 13(1): 35-43. (In Thai)
Kengganpanich M, Dolampornphisuts T, Kengganpanich T. Developing model for helping smoking cessation and non-communicable disease treatment by foot reflexology. Bangkok: Chareondee-Munkong Publishing; 2018. (In Thai)
National Statistics Institute. The smoking and drinking behaviour survey 2017. Bangkok: Pimdeekarnpim Co., Ltd.; 2018. (In Thai)
Chow SC, Shao J, Wang H. Sample size calculations in clinical research. 2nd ed. London: Chapman and Hall CRC; 2008.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The fagerstrom test for nicotine dependence: A revision of the fagerstrom tolerance questionnaire. Br J Addict 1991; 86(9): 1119-27.
Vathesatogkit K, ed. Manual: You can do… quit smoking. Bangkok: Action on Smoking and Health Foundation Thailand; 2014. (In Thai)
World Health Organization. Smoking cessation and treatment of tobacco dependence. Bangkok: Chareondee-Munkong Publishing; 2016. (In Thai)
The Department of Health and Human Services. Treating tobacco use and dependence: 2008 update-clinical practice guideline. Available from https://www.ncbi.nlm.nih.gov/books/NBK63952/, accessed 10 December, 2019.
Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q 1988; 15(2): 175–83.
Prochaska JO, Redding CA, Evers KE. The Transtheoretical Model and Stages of Change. In: Glanz K, Rimer BK, Viswanath K. eds. Health Behavior and Health Education. 4th ed. San Francisco: Jossey-Bass; 2008. p.97-122.
Pantaewan P, Prasittivatechakool A. Application of transtheoretical model and smoking behavior modification. Journal of the Royal Thai Army Nurses 2014; 15(1): 36-44. (In Thai)
Raya P, Benjakul S, Kengganpanich M, Kengganpanich T, Lattanand K. Effects of the smoking cessation program applying transtheoretical model among smokers at Wongwon Sub-disrict, Kuntung District, Trang Province. Journal of Boromarajonani College of Nursing, Bangkok 2015; 31(2): 9-25. (In Thai)
Suankul P, Imamee N, Therawiwat M, Amnajsatsue K. An application of stages of change theory on smoking cessation among the transcripts in Vipawadeerangsit Camp, Suratthani Province. Journal of Health Education 2009; 32(2): 33-7. (In Thai)
Bunyawan B, Kaewpan W, Karumkorn S, Sittirak N. Effectiveness of a smoking cessation program
applying the transtheoretical model for security officers in Siriraj hospital. Kuakarun Journal of
Nursing 2012; 19(2): 88-102. (In Thai)
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