Nurses' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in China

Authors

  • Sophia S.C. Chan,

    1. Sophia S.C. Chan, RN, MEd, PhD, Pi Iota, Head, Department of Nursing Studies, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Linda Sarna, RN, DNSc, Gamma Tau, Professor, School of Nursing, University of California, Los Angeles, CA; David C.N. Wong, MSc, Doctoral candidate, Department of Nursing Studies and Public Health Research Centre, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Tai-Hing Lam, MD, Head and Chair Professor, Department of Community Medicine and School of Public Health, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. We thank the Committee on Research and Conference Grants, University of Hong Kong, for funding this study. We are grateful to the five university schools of nursing, the hospital nurses and their managers in China who facilitated or participated in this study. We also thank Miss BY Huang, for translating the questionnaire. Lastly, Dr. Chan thanks the Harvard School of Public Health for hosting her sabbatical leave during which this writing was completed. Correspondence to Dr. Chan, Head, Department of Nursing Studies, The University of Hong Kong, 4/F, William M W Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China. E-mail: nssophia@hkucc.hku.hk
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  • Linda Sarna,

    1. Sophia S.C. Chan, RN, MEd, PhD, Pi Iota, Head, Department of Nursing Studies, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Linda Sarna, RN, DNSc, Gamma Tau, Professor, School of Nursing, University of California, Los Angeles, CA; David C.N. Wong, MSc, Doctoral candidate, Department of Nursing Studies and Public Health Research Centre, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Tai-Hing Lam, MD, Head and Chair Professor, Department of Community Medicine and School of Public Health, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. We thank the Committee on Research and Conference Grants, University of Hong Kong, for funding this study. We are grateful to the five university schools of nursing, the hospital nurses and their managers in China who facilitated or participated in this study. We also thank Miss BY Huang, for translating the questionnaire. Lastly, Dr. Chan thanks the Harvard School of Public Health for hosting her sabbatical leave during which this writing was completed. Correspondence to Dr. Chan, Head, Department of Nursing Studies, The University of Hong Kong, 4/F, William M W Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China. E-mail: nssophia@hkucc.hku.hk
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  • David C.N. Wong,

    1. Sophia S.C. Chan, RN, MEd, PhD, Pi Iota, Head, Department of Nursing Studies, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Linda Sarna, RN, DNSc, Gamma Tau, Professor, School of Nursing, University of California, Los Angeles, CA; David C.N. Wong, MSc, Doctoral candidate, Department of Nursing Studies and Public Health Research Centre, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Tai-Hing Lam, MD, Head and Chair Professor, Department of Community Medicine and School of Public Health, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. We thank the Committee on Research and Conference Grants, University of Hong Kong, for funding this study. We are grateful to the five university schools of nursing, the hospital nurses and their managers in China who facilitated or participated in this study. We also thank Miss BY Huang, for translating the questionnaire. Lastly, Dr. Chan thanks the Harvard School of Public Health for hosting her sabbatical leave during which this writing was completed. Correspondence to Dr. Chan, Head, Department of Nursing Studies, The University of Hong Kong, 4/F, William M W Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China. E-mail: nssophia@hkucc.hku.hk
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  • Tai-Hing Lam

    1. Sophia S.C. Chan, RN, MEd, PhD, Pi Iota, Head, Department of Nursing Studies, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Linda Sarna, RN, DNSc, Gamma Tau, Professor, School of Nursing, University of California, Los Angeles, CA; David C.N. Wong, MSc, Doctoral candidate, Department of Nursing Studies and Public Health Research Centre, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Tai-Hing Lam, MD, Head and Chair Professor, Department of Community Medicine and School of Public Health, L.K.S. Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. We thank the Committee on Research and Conference Grants, University of Hong Kong, for funding this study. We are grateful to the five university schools of nursing, the hospital nurses and their managers in China who facilitated or participated in this study. We also thank Miss BY Huang, for translating the questionnaire. Lastly, Dr. Chan thanks the Harvard School of Public Health for hosting her sabbatical leave during which this writing was completed. Correspondence to Dr. Chan, Head, Department of Nursing Studies, The University of Hong Kong, 4/F, William M W Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China. E-mail: nssophia@hkucc.hku.hk
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Abstract

Purpose: To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses.

Design: A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003.

Methods: 2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity.

Findings: 2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions.

Conclusions: Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives.

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