Koori Quit Pack: A feasibility study of a multi-component mailout smoking cessation support for Aboriginal and Torres Strait Islander people: "I would recommend it to anybody. It's just so much easier"

Introduction: Smoking is the leading cause of preventable death among Aboriginal and Torres Strait Islander people. Aims and Methods: The Koori Quit Pack study aimed to assess the feasibility of a multi-component mailout smoking cessation intervention to reduce smoking among Aboriginal and Torres Strait Islander people. A non-randomized, single-group feasibility study was conducted among Aboriginal and Torres Strait Islander people who reported current smoking. The intervention package included information pamphlets and resources on quitting, referral offer to Aboriginal Quitline and optional free Nicotine Replacement Therapies (NRT). Follow-up was conducted at 2-week, 6-week, 10-week, and 6-month post-recruitment. Feasibility outcomes were recruitment and retention rates, uptake of intervention components, and smoking abstinence at 6-week follow-up (primary endpoint). Cessation outcomes were analyzed using both a complete case analysis and intention-to-treat approach. Results: 165 participants were recruited, 111 (67.3%), 79 (47.9%), 59 (35.8%), and 94 (57%) participants completed the 2-week, 6-week, 10-week, and 6-month follow-up. At 10-week follow-up, 40.7% of participants used pamphlets and booklets, 13.6% used Quitline and > 90% used NRT. At 6-week follow-up, 87.3% reported a quit attempt and 46.8% sustained quitting. 46.8% were continuously smoke-free at the 6-week timepoint. The complete case analysis and the intention-to-treat analysis at 6 months show a 7-day self-reported point prevalence abstinence of 34% and 19.4% respectively. Conclusions: The Koori Quit Pack mailout smoking cessation program was feasible to support Aboriginal and Torres Strait Islander people. The intervention resulted in a high smoking cessation rate and should be upscaled, implemented, and evaluated nationally. Implications: Aboriginal and Torres Strait Islander people are disproportionately impacted by tobacco-related harms; however, the majority want to quit or wish they never took up smoking. Mailout cessation support is feasible, overcomes access barriers to evidence-based support and increases quitting success. We recommend a national mailout smoking cessation program is implemented for, and by Aboriginal and Torres Strait Islander people to accelerate declines in smoking prevalence to eliminate tobacco-related death and disease.