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Quitting Smoking in Mainland China

A New Role for Hospital-Based Nurses

Li, Weijia, BNurs; Kung, Kenny, FHKAM, MRCGP, FRACGP; Li, Zhe, MNurs; Hui, Christopher, MBBS, MRCP; Holroyd, Eleanor, PhD; Wong, William C. W., MD, MPH, FRCGP

doi: 10.1097/HNP.0000000000000303

China has more than 300 million cigarette smokers and 1 million deaths every year attributed to smoking. Despite its huge economic implications, the lack of smoking and associated lifestyle-related data on China's outpatients makes it difficult for health care professionals to provide individualized assessments and targeted interventions. This study aimed to identify factors to inform nurse-led smoking behavioral assessments and cessation interventions. Clinical data from new patients attending the family medicine outpatient department from a large tertiary hospital in a major Southern China city were collected between March and December 2015. Data including basic demographics, medical history, vaccination history, current medication, and information on lifestyle risk factors were collected by frontline nurses during nursing assessment on their initial visit. Chi-square and Student's t tests were used as univariate analysis and post hoc regression analysis to explore which factors contributed toward smoking cessation. Of 7913 eligible visits, smokers and ex-smokers accounted for 13.5% and 2.4% of new patients, respectively, with a majority of them being young and male (gender ratio of 8:1) smokers. Multiple behavioral risks and comorbidities such as hypertension and diabetes mellitus in smokers were common; for example, 17.9% of smokers were also current drinkers, making alcohol users 8.5 to 16.7 times more likely to have smoked. Ex-smokers were more likely to be divorced, to be ex-drinkers, or to have higher diastolic blood pressure and concurrent hypertension. Smoking and associated lifestyle risk assessments run by registered nurses should be incorporated into current outpatient health histories and in targeted smoking cessation intervention programs.

Outpatient Administrative Office (Ms Weijie Li) and Central Nursing Department (Mr Zhe Li), The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, People's Republic of China; Department of Family Medicine and Primary Care (Mr Kung and Dr Wong), Division of Respiratory and Critical Care Medicine, Department of Medicine (Dr Hui), and Department of Family Medicine & Primary Care, Li Ka Shing Faculty of Medicine (Dr Wong), The University of Hong Kong, Pokfulam, Hong Kong; Nursing Research, Auckland University of Technology, Auckland, New Zealand (Dr Holroyd); and Nursing Capacity Development, The Aga Khan University, Uganda, East Africa (Dr Holroyd).

Correspondence: William C. W. Wong, MD, MPH, FRCGP, Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, 161 Main St, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong (

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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