RESEARCH PAPER
Chinese pediatrician beliefs about counseling and medications for parents who smoke: a survey in southern China
Kaiyong Huang 1
,  
Abu S. Abdullah 2, 3, 4  
,  
Jing Liao 5
,  
Haiying Huo 1
,  
Li Yang 1
,  
Zhiyong Zhang 1
,  
 
 
More details
Hide details
1
School of Public Health, Guangxi Medical University, Nanning, China
2
Global Health Program, Duke Kunshan University, Kunshan, China
3
Duke Global Health Institute, Duke University, Durham, USA
4
Boston University School of Medicine, Boston Medical Center, Boston, USA
5
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
6
MGH Center for Child and Adolescent Health Research and Policy, Harvard Medical School, Boston, USA
CORRESPONDING AUTHOR
Abu S. Abdullah   

Global Health Program, Duke Kunshan University, Duke Avenue, Kunshan, Jiangsu 215316, China
Guangmin Nong   

Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
Publish date: 2015-04-07
 
Tobacco Induced Diseases 2015;13(April):10
ABSTRACT
Background:
Pediatricians play an important role in promoting smoking cessation among the parents of young children as more behavioral counseling and cessation treatment are made available in the Chinese healthcare system. However, beliefs about the effectiveness of these interventions can influence pediatricians’ recommendations to their patients. This study examined pediatricians’ beliefs regarding effectiveness of counseling and medications for smoking cessation.

Methods:
A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected southern Chinese hospitals, during September to December 2013. A self-administered questionnaire was used for data collection. We used chi square tests and multinomial logistic regression analysis to identify factors associated with beliefs regarding effectiveness of counseling and medications for smoking cessation.

Results:
Beliefs of the respondents (504/550; 92% response rate) were divided regarding the effectiveness of counseling and medications for smoking cessation. Sixty percent believed that physician counseling is effective for smoking cessation; 53% believed pharmacological products (or medications) are effective. Factors that were associated with positive beliefs towards the effectiveness of counseling included: believing about the professional responsibility to discuss smoking cessation, being confident in discussing smoking cessation or SHS exposure reduction with patients’ parents, believing that health professionals should routinely ask about their patients smoking habits, believing that health professionals should routinely advise their smoking patients to quit smoking, possessing adequate knowledge in quitting smoking, and being able to assess smokers different stages of readiness to quit. Most of the above factors were also associated with the belief that medication is effective for smoking cessation.

Conclusions:
A substantial proportion of Chinese pediatricians believed that cessation counseling and medications are not effective, which is not supported by current evidence in the field. Several factors including individual, practice level and health system level characteristics were associated with their belief. Training efforts are needed to influence pediatricians’ beliefs regarding the effectiveness of cessation counseling and medications.

 
REFERENCES (29)
1.
Yang GH, Ma JM, Liu N, Zhou LN. Smoking and passive smoking in Chinese, 2002. Zhonghua Liu Xing Bing Xue Za Zhi. 2005;26:77–83.
 
2.
Center for Disease Prevention and Control. Chinese Ministry of Health: GATS china report. Beijing: China CDC; 2010.
 
3.
Liu Y, Chen L. New medical data and leadership on tobacco control in China. Lancet. 2011;377:1218–20.
 
4.
Coffield AB, Maciosek MV, McGinnis JM, Harris JR, Caldwell MB, Teutsch SM, et al. Priorities among recommended clinical preventive services. Am J Prev Med. 2001;21(1):1–9.
 
5.
Centers for Disease Control and Prevention, USA. The surgeon General’s 1990 report on the health benefits of smoking cessation executive summary - preface. MMWR Recomm Rep. 1990;39(RR-12):viii–xv.
 
6.
Zhou J, Abdullah AS, Pun VC, Huang D, Lu S, Luo S. Smoking status and cessation counseling practices among physicians, Guangxi, China, 2007. Prev Chronic Dis. 2010;7(1):A15.
 
7.
U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Washington, DC: U.S: Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion; 2006.
 
8.
Rowland D, Lyons B, Salganicoff A, Long P. A profile of the uninsured in America. Health Aff. 1994;13(2):283–7.
 
9.
Winickoff JP, Buckley VJ, Palfrey JS, Perrin JM, Rigotti NA. Intervention with parental smokers in an outpatient pediatric clinic using counseling and nicotine replacement. Pediatrics. 2003;112(5):1127–33.
 
10.
Abdullah AS, Ma ZY, Liao J, Huang KY, Yang L, Zhang ZY, et al. Addressing parental smoking in pediatric settings of Chinese hospitals: a qualitative study of parents. Biomed Res Int. 2014;2014:382345.
 
11.
Vogt F, Hall S, Marteau TM. General practitioners’ beliefs about effectiveness and intentions to prescribe smoking cessation medications: qualitative and quantitative studies. BMC Public Health. 2006;6:277.
 
12.
Steinberg MB, Delnevo CD. Physician beliefs regarding effectiveness of tobacco dependence treatments: results from the NJ Health Care Provider Tobacco Survey. J Gen Intern Med. 2007;22(10):1459–62.
 
13.
Vogt F, Hall S, Marteau TM. General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005;100(10):1423–31.
 
14.
Williams JM, Zimmermann MH, Steinberg ML, Gandhi KK, Delnevo C, Steinberg MB, et al. A comprehensive model for mental health tobacco recovery in New jersey. Adm Policy Ment Health Ment Health Serv Res. 2011;38(5):368–83.
 
15.
Liao J, Abdullah AS, Nong GM, Huang KY, Lin LD, Ma ZY, et al. Engaging Chinese pediatricians on secondhand smoke exposure assessment and counseling: a qualitative study. BMC Pediatrics. 2014;14:226.
 
16.
Zapka JG, Pbert L, Stoddard AM, Ockene JK, Goins KV, Bonollo D. Smoking cessation counseling with pregnant and postpartum women: a survey of community health center providers. Am J Public Health. 2000;90(1):78–84.
 
17.
Zapka JG, Fletcher K, Pbert L, Druker SK, Ockene JK, Chen L. The perceptions and practices of pediatricians: tobacco intervention. Pediatrics. 1999;103(5):e65.
 
18.
Winickoff JP, Tanski SE, McMillen RC, Klein JD, Rigotti NA, Weitzman M. Child health care Clinicians’ Use of medications to help parents quit smoking: a national parent survey. Pediatrics. 2005;115(4):1013–7.
 
19.
Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2005;2, CD001292.
 
20.
Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2005;4, CD001007.
 
21.
Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2008;1, CD000146.
 
22.
Croghan IT, Hurt RD, Dakhil SR, Croghan GA, Sloan JA, Novotny PJ, et al. Randomized comparison of a nicotine inhaler and bupropion for smoking cessation and relapse prevention. Mayo Clin Proc. 2007;82(2):186–95.
 
23.
Hays JT, Hurt RD, Rigotti NA, Niaura R, Gonzales D, Durcan MJ, et al. Sustained release bupropion for pharmacologic relapse prevention after smoking cessation: a random- ized, controlled trial. Ann Int Med. 2001;135(6):423–33.
 
24.
Jorenby DE, Leischow SJ, Nides MA, Rennard SI, Johnston JA, Hughes AR, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. New Engl J Med. 1999;340(9):685–91.
 
25.
Steinberg MB, Foulds J, Richardson DL, Burke MV, Shah P. Pharmacotherapy and smoking cessation at a tobacco dependence clinic. Prev Med. 2006;42(2):114–49.
 
26.
Cao RG, Xu GH, Zhao N, Zen FY, Wang JB, Feng ML. Effect on doctor’s knowledge, attitude, and practice of tobacco control of creating smoke-free hospital in 60 hospitals. Chin Hosp. 2011;15(7):24–8.
 
27.
Zhu SH, Anderson CM, Tedeschi GJ, Rosbrook B, Johnson CE, Byrd M, et al. Evidence of real-world effectiveness of a telephone quitline for smokers. New Engl J Med. 2002;347(14):1087–93.
 
28.
Swartz LH, Noell JW, Schroeder SW, Ary DV. A randomised control study of a fully automated internet based smoking cessation programme. Tob Control. 2006;15(1):7–12.
 
29.
Walters ST, Wright JA, Shegog R. A review of computer and internet – based interventions for smoking behavior. Addict Behav. 2006;31(2):264–77.
 
 
CITATIONS (1):
1.
Are Chinese pediatricians missing the opportunity to help parents quit smoking?
Jing Liao, Jonathan P. Winickoff, Guangmin Nong, Kaiyong Huang, Li Yang, Zhiyong Zhang, Abu S. Abdullah
BMC Pediatrics
 
eISSN:1617-9625