Providing smoking cessation services and its relationship with knowledge and attitudes: a comparison of the Guangzhou and Hong Kong nurses

Abstract

China is the largest consumer of tobacco in the world and there are currently 360 million smokers in China. Smoking cessation is critical in fighting the tobacco epidemic, and nurses, the largest group of health care providers, play an important role in smoking cessation. China now is only at its early stage in capacity building for smoking cessation counsellors and the experience of Hong Kong, 20 years ahead in tobacco control, in developing nurses in smoking cessation counselling might be useful for reference. The study aimed to compare the differences between 1,541 Guangzhou and 1,843 Hong Kong nurses' knowledge, attitudes and practices with regard to tobacco control and smoking cessation, and the predictors of practising smoking cessation intervention. We found that nurses in both Guangzhou and Hong Kong showed inadequate knowledge on tobacco control and smoking cessation counselling, and in particular, are insufficient in providing “initiation and advice” and “follow-through” actions based on the 5As (Ask, Advise, Assess, Assist, Arrange) framework. Multivariate linear regressions revealed that the specific knowledge was positively associated with both “initiation and advice” and “follow-through” interventions in both regions; while the attitude towards the banning of tobacco promotion was positively associated with both actions in Hong Kong nurses but was negatively associated with the “follow-through” action in smoking cessation intervention in Guangzhou nurses; and the attitude towards their own responsibility in smoking cessation was only positively associated with the “initiation and advice” smoking cessation interventions among Hong Kong nurses. The findings suggested that basic and continuing education and training in smoking cessation should emphasize the specific health hazards of smoking, its risks and mortality. Moreover, the nursing curriculum should include programmes to cultivate a sense of responsibility among the nurses.