Helping In-patients to Quit Smoking by Understanding Their Risk Perception, Behavior, and Attitudes Related to Smoking

This study aims at understanding the needs and concerns of Chinese current smoking patients, including their risk perceptions, and the behavior, attitudes, and experiences related to smoking and smoking cessation. Specifically, how smokers overcome withdrawal symptoms and cigarette cravings, as a result of banning on smoking in hospitals, will be explored. In addition, whether smokers will stop, resume or continue smoking after hospitalization will be investigated.

As about 400,000 hospitalizations are attributable to smoking annually in Hong Kong, it is an excellent "teachable moment" for healthcare professionals to help patients quit smoking. To our knowledge, this is the first study to investigate the needs and concerns of Chinese current smoking patients, including their risk perceptions, and the behavior, attitudes, and experiences related to smoking and smoking cessation. The findings of this study have important implications for research and clinical practice.

Understanding how hospitalized smokers perceive the risks of smoking, and their behaviour, attitudes, experiences related to smoking, as well as their view on hospital smoking cessation service are essential prerequisites for the design of an effective and appropriate smoking cessation intervention that can help patients achieve a greater level of smoking abstinence and a lower level of relapse. Moreover, the results of this study can guide the development of protocols and interventions that will demystify the misconceptions about smoking among hospitalized smokers, increase their perception of the risks of continued smoking and benefits of quitting. Additionally, it is crucial to motivate more healthcare professionals to assess health behaviors of hospitalized smokers and to implement evidence-based interventions to help them quit smoking. Most importantly, healthcare professionals should be offered relevant training so as to enhance their self-efficacy and confidence in promoting smoking cessation to patients.

The study consists of 2 phases. During phase 1, a purposive sample of 30 current adult smokers who admit to either medical or surgical units of one of the largest cute hospitals in Hong Kong will be invited to have a 60-minute semi-structured interview. The risk perceptions, and the behaviour, attitudes, and experiences related to smoking and smoking cessation amongst Chinese current smoking patients will be explored. Concerning phase 2, a convenience sample of 382 adult patients who are current smokers or ex-smokers in the three out-patient clinics will be invited to response to the questionnaires. Based on the findings of Phase 1 study, a survey study will be conducted to further explore the behaviour, attitudes, and experiences related to smoking and smoking cessation amongst those patient who smoked before their admission to hospitals.

Eligibility Criteria:
Inclusion Criteria:

1. aged 18 years or above
2. able to speak Cantonese Phase 1:(3) current smokers, either occasional or daily(4) hospitalized for at least 48 hours Phase 2:(3) current smokers who have resumed smoking or ex-smokers who have quitted smoking after hospitalization(4) admitted to hospitals, either medical or surgical units during the past 3 months.

Exclusion Criteria:

1. unstable medical conditions, as advised by the doctor in charge
2. poor cognitive state or active psychotic symptoms