Chinese pediatrician beliefs about counseling and medications for parents who smoke: a survey in southern China

Abstract

BackgroundPediatricians 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.MethodsA 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.ResultsBeliefs 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.ConclusionsA 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.

Are Chinese pediatricians missing the opportunity to help parents quit smoking?

“…Research had shown that pediatricians who received formal training in smoking cessation counseling reported higher levels of self-efficacy for smoking cessation [ 19 ] and provided more smoking cessation counseling to their patients [ 20 ]. A survey in China reported higher confidence to provide smoking cessation service among physicians who received training on tobacco use prevention and cessation [ 26 ]. At the same time, only less than half of pediatricians had appropriate knowledge about health risk of smoking and SHS, and about half of the pediatricians did not believe the fact that smoking cessation counseling and medication are effective in promoting smoking cessation.…”

“…The questionnaire was developed with reference to the questionnaires previously used by the investigators team in the United States [ 9 ] and in China [ 25 ]. The details of the questionnaire have been described elsewhere [ 26 ]. Briefly, the questionnaire obtained information on the subject’s demographic and medical training background, smoking behavior (smoker, non-smoker), counseling practices for smoking cessation and secondhand smoke (SHS) exposure to children and other relevant factors.…”