Investigation of Hong Kong doctors' current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependency.

BACKGROUND: Physicians play a crucial role in promoting smoking cessation. However, there are lack of data on Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation. Understanding of these indicators is important in the design of any effective intervention program targeting doctors. METHODS: To assess Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation, a mailed questionnaire survey was conducted among 4,000 doctors registered with the Hong Kong Medical Association (HKMA) in 2002. RESULTS: Of the 757 respondents (18.9% response rate), 78% were male, 94% were non-smokers and 50% had received no basic training on smoking cessation. More than half of the doctors did not hold adequate knowledge (53%) or favorable attitudes (55%) towards smoking cessation; 44% were less confident in their smoking cessation skills. About 77% of the doctors obtained information on their patients' smoking status and recorded it in their medical record, and 29% advised all smoking patients to quit. Doctors who gave smoking cessation advice were more likely to be aged above 50 years, with more than 30 years' practice experience, working in the private sector, non- or ex-smokers, with more positive beliefs towards smoking cessation, and with higher confidence in smoking cessation skills (p < 0.001). Different factors associated with establishing and recording smoking status, arranging follow-up sessions, acquiring more knowledge and developing a more favorable attitude and greater confidence on smoking cessation-related matters were also identified. CONCLUSION: The survey has shown that existing smoking cessation service provision in Hong Kong for patients who smoke is inadequate, and has identified a lack of smoking cessation skills among doctors. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers to quit smoking.

Promoting smoking cessation among the elderly: what are the predictors of intention to quit and successful quitting?

PURPOSE: To assess the predictors of smoking cessation and intention to quit among the Chinese elderly smokers. DESIGN: A cross-sectional survey of elderly smokers. SETTING: Shamsuipo district, Hong Kong. SUBJECT: A total of 1,318 elderly were interviewed (response rate = 83%). MEASURES: A structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background and smoking habits. The predictors for successful quitting and intention to quit were assessed by chi-square tests and multiple logistic regression. RESULTS: Of the respondents, 20.2% were current smokers, 25.4% were ex-smokers, and 54.4% were never smokers. Of the smoker (current and ex-smokers) respondents, 55.7% (335/601) had successfully quit at the time of enumeration. The predictors of quitting were living with others, receiving assistance for mobility, being nondrinkers, smoking for shorter duration, and smoking more cigarettes per day. Having health problems in the past, smoking for shorter duration, and smoking fewer cigarettes per day were predictors of intention to quit smoking. CONCLUSION: The study identified several predictors of successful quitting that could help improve the provision of current smoking cessation services. Population-based smoking cessation programs, especially those targeted to elderly, should take these predictors into consideration in the design of interventions.