eResources for Health Care Professionals
Welcome to this eLearning ABC module!
Studies showed that a three-minute advice on smoking cessation by a health care professional would significantly increase the chance of successful quitting. A comprehensive smoking cessation service would not only broaden your scope of clinical service, but also help establish rapport between you and your clients.
1. How you can make a difference
Smoking is the biggest preventable cause of death in Hong Kong and in many countries. Although the smoking prevalence has dropped from 23.3% in 1982 to 10.2% in 2019, the number of adult daily cigarette smoker is still as high as 637,900. Disease caused by smoking and secondhand smoke imposed a HK$5.5 billion economic and medical burden on our society annually. As such, Hong Kong and many countries have enhanced the efforts in promoting smoking cessation in addition to strengthening their tobacco control measures and legislations.
According to the Thematic Household Survey in 2019, about 234,000 smokers in Hong Kong wanted to quit. Apart from their own or family health reason, a significant portion of ex-daily smokers in Hong Kong decided to quit because they had been advised by health care professionals to do so.
Quitting is not as easy as it sounds. Tobacco dependence is a chronic disease that often requires repeated intervention and multiple quit attempts. More than half would need to go through the process at least twice to succeed in kicking the habit. Apart from dealing with the problem of nicotine dependence, we have to bear in mind that behavioural modification and adjustment on lifestyle during the course of smoking cessation are just as important. A comprehensive cessation programme should encompass all these elements.
Even if a comprehensive counselling session is not feasible during your daily encounter with smokers, you can perform “ABC” to help them quit smoking.
2. What is ABC for quitting smoking?
A - Ask
What and whom should I ask?
It is important that you ask all clients their smoking status and document it in their health record. For those who smoke or have recently stopped smoking, the status should be checked and updated regularly e.g. annually.
For smokers, enquire on their smoking history -
B - Brief Advice
You should:
Counselling (motivational interviewing) and medication are effective when used by themselves for treating tobacco dependence. The combination of counselling and medication, however, is more effective than either alone.
Individual, group and telephone counselling are effective. Their effectiveness increases with treatment intensity.
Motivational Interviewing (MI) was developed by William Miller and Stephen Rollnick in the 1980s. MI is defined as a collaborative conversation style for strengthening a person’s own motivation and commitment to change. It is a patient-centered style of counselling designed to help people change through exploring and resolving ambivalence about change.
MI is being adopted in helping people to quit smoking. A large and increasing number of controlled research studies have shown that MI is significantly more effective than no treatment for substance use including tobacco use.
Smokers often have insufficient understanding of the possible withdrawal symptoms in the process of quitting. Once a smoker refrains from smoking, the nicotine level inside his/her body will start to drop gradually. The quitter may experience short-term discomforts such as dizziness, headache, fatigue, poor concentration, dry mouth and throat, cough and hunger. All these symptoms increase the chance of failure in quit attempt but most of these discomforts would subside in 2 to 3 weeks’ time.
Studies showed that pharmacotherapies can alleviate withdrawal symptoms and increase the success rate effectively. Besides, the medication can also become an incentive for the quitter to attend follow-up consultation on schedule. Common first-line supplementary medication for smoking cessation nowadays can be broadly divided into two categories: nicotine replacement therapy (NRT) and non-nicotine medications. For details, please go to drugs for quitting smoking .
For smokers who find it inconvenient to receive smoking cessation service and wish to quit on their own, you can pass them the following practical tips.
C - Cessation Support
You should recommend that the best results are achieved by combining behavioural therapy with medicine.
The hotline (1833 183) is run by the nurses of the Department of Health. It coordinates various smoking cessation services provided by the Department of Health (DH), Tung Wah Group of Hospitals (TWGHs), Hospital Authority (HA), Pok Oi Hospital (POH). United Christian Nethersole Community Health Service (UCN) and a local university (Youth Quitline).
A computerised call handling system is also set up to provide information on smoking cessation and medication in Cantonese, Putonghua and English round the clock. Users may assess their nicotine dependence via the system and obtain the test result as well as other useful information by fax.
Medications and counselling for smoking cessation are provided at centres or clinics. At present, there are a number of smoking cessation clinics run by DH, TWGHs, POH, UCN, HA and various organisations. Some private doctors and private hospitals also provide smoking cessation services that smokers may join.
Tung Wah Group of Hospitals - Integrated Centre on Smoking Cessation
The Department of Health collaborates with the Tung Wah Group of Hospitals to launch a community-based smoking cessation programme. Several Integrated Centres on Smoking Cessation are established by the Tung Wah Group of Hospitals to provide the community with free smoking cessation services in various time frames including evening hours and weekends.
Hospital Authority
The Hospital Authority (HA) operates over 50 Smoking Counselling and Cessation Centres, providing smoking cessation services through counselling and provision of pharmacological interventions.
HA also has a "Quitline" (2300 7272) for enquiry and telephone counselling services.
Pok Oi Hospital
Territory-wide free smoking cessation services including counselling and acupuncture are provided by Pok Oi Hospital Chinese medicine practitioners in polyclinics and mobile clinics.
United Christian Nethersole Community Health Service
The United Christian Nethersole Community Health Service aims to provide free smoking cessation services targeting ethnic minorities and new immigrants. The service provides treatment to quit smoking and multilingual information on smoking cessation to cater the need of this community. The enquiry telephone number is 3156 9012.
For more information, call our Quitline 1833 183.
3. Take Home Message
4. Assessment
1 CME or CNE point will be awarded to those who attain a passing score of 60%.
Please click here to enter the assessment section.