19 Jan 2010

A study conducted by The University of Hong Kong earlier ascertained that female smokers encounter more difficulties and have less confidence in quitting when comparing to their male counterparts. This results in a lack of determination to stop smoking and thus leads to a low quit rate. In a project to assist female smokers in kicking the bad habit, the Department of Nursing Studies and School of Public Health of The University of Hong Kong have offered gender-specific smoking cessation counselling since 2006. In the past 3 years, nearly 700 Hong Kong residents called the HKU gender-specific smoking cessation hotline and 349 female smokers received counselling.

Project overview

This project aims to publicise quitting among female smokers, encourage and support those who want to quit by face-to-face or telephone counselling. In order to raise public awareness on health hazards of smoking and urge female smokers to quit, we joined forces with local women organizations to form “Women Against Tobacco Taskforce” (WATT). A number of training workshops and health talks on smoking cessation were organized for staff and volunteers of the WATT. These activities equipped them with the knowledge and skills to give brief cessation advice for female smokers in the community. Besides, a gender-specific smoking cessation hotline has been launched to receive public enquiries and to provide smoking cessation counselling services.

Gender-specific smoking cessation counseling

Experienced nurse counsellors provide gender-specific smoking cessation counselling to female smokers. The counselling included explaining the adverse effects of smoking on women’s health, identifying the barriers and facilitators of quitting and working with the smoker to design an individualized quit plan. After the counselling, the smokers were followed-up at 1-week, 1-month, 3-month and 6-month intervals. The continuous assistance allows our counsellors to monitor the participants’ quitting processes and provide further reinforcement on behavioral changes.

Findings

The smoking cessation counselling service started from November 2006. Until 31 October 2009, 332 female smokers have received counselling and completed 6-month follow up. The results are as follows:

Profile of the participants: 39.2% and 36.1% of participants were aware of our service through website and mass media respectively. They were 35 years old on average, with 41.6% of them married and 66.3% employed. The majority of participants (68.3%) reported good perceived health status.

Nicotine dependence: Having started smoking at their early adulthood (18 years old on average), participants smoked 14 cigarettes per day on average and preferred to smoke when feeling relaxed and after meal. 32.2% of them have severe nicotine dependence and about 16.6% were in action stage of quitting smoking.

Past quitting experience: Most participants (70.8%) tried to quit smoking in the past but failed. 46% of them even tried 2 – 5 times, but few (0.9%) sought help from health care professionals when they quit smoking. Being irresistible to the desire of smoking was cited as the main reason for their failure.

Success at 6-month follow up: 280 (85.1%) cases were successfully followed and 26.5% (n=88) reported to have quitted smoking for 7 the past days. Those who continued to smoke reduced their daily cigarette consumption significantly from 15 to 9 on average. Their perceived health status and self-efficacy on resisting smoking were also enhanced.

Analysis of the quitting processes: In-depth analysis was conducted to understand the change of the participants’ smoking behavior after receiving counseling. Three distinct groups of smokers were found namely the quitters, reducers, and resistant smokers. All participants were motivated to change their smoking behavior (reduce smoking) after receiving the intervention. Quitters were able to quit successfully within one month and sustained until 6 month. Reducers cut down cigarette consumption >50% compared to baseline, and resistant smokers cut down cigarette consumption, but to a lesser extent, and failed to quit. Quitters smoked less, had perceived higher confidence and importance in quitting, had lower nicotine dependence, perceived better health, and had a higher stage of readiness to quit, at baseline.

Conclusions

We have strived to promote quitting among female smokers in collaboration with community groups. The findings shed light on the effectiveness of our gender-specific smoking cessation counselling programme, with a slightly higher rate of tobacco abstinence (26.5%) achieved in a comparison with recent local studies. Additionally, the daily cigarette consumption for those who continued smoking was significantly reduced, and their self-efficacy in resisting smoking enhanced. Every woman smoker may have different processes of quitting and tailored intervention was recommended.

Professor Sophia Chan Siu-chee, Professor and Head of Department of Nursing Studies said, “Many women care about their health these days, and with the help of professional counseling provided by nurses, the female smokers were protected from the temptation of tobacco, and successfully quit or reduce smoking. At the beginning of this new year, I urge smokers to make a resolution to quit smoking and lead a healthy lifestyle.”

In the last Budget Speech, the Financial Secretary raised the tobacco tax by 50 per cent. During that time, more smokers were motivated to quit smoking and seek smoking cessation services. Professor Lam Tai-hing, Director of School of Public Health added, “An increase in tobacco tax should remind smokers of the fatal consequence of smoking, and prompted smokers to quit. Research studies have shown that 50% of smokers who continue to smoke will be killed by tobacco prematurely. Second hand smoke is also proven to cause severe damage to health of both smoking and nonsmoking children and adults. For your own and public’s sake, quit smoking now!”

The “HKU Smoking Cessation Counselling Service for Female Smokers” is totally FREE of CHARGE. Those who are interested in this service please call Ms Wan of the Department of Nursing Studies, HKU at 6752 6266 or visit our website on www.wquit.hku.hk for further information. We thank the Health Care Promotion Fund, Food and Health Bureau, Hong Kong SAR Government and the Hong Kong Council on Smoking and Health which provided financial support to our project.

Download Presentation Slides

To use the press release photo(s) for any publishing, publicity and related purpose, photo courtesy should be given to “Li Ka Shing Faculty of Medicine, The University of Hong Kong”