Smoking has harmful effects on nearly every organ of the body and causes seven million deaths
worldwide every year. Although the prevalence of daily cigarette smoking in Hong Kong has
decreased from 23.3% in 1982 to 10.5 % in 2015, there are still 641,300 daily smokers and
400,000 hospitalisations per year that are attributable to smoking. Having a disease and
requiring medical attention present an excellent 'teachable moment' and opportunity for
initiating smoking cessation in patients, because they will be more likely to be motivated to
alter their habits and improve their health. However, cigarette smoking is addictive and
quitting is very difficult, with a high rate of relapse, particularly among patients with
chronic diseases.
During the past decade, the investigators have conducted several trials on promoting smoking
cessation to smokers with chronic diseases, including cardiac, type 2 diabetes mellitus, and
cancer. It is found that many smokers with chronic diseases had a long smoking history, high
nicotine dependency, no quit attempt, and no intention to quit. Results of these studies
indicated that about 68% smokers with cardiac diseases, 70% with diabetes mellitus and 73%
with cancer recruited in Special Out-Patient Clinics (SOPC) were still in the
pre-contemplation stage. This revealed that most Hong Kong smokers with chronic diseases
perceived more barriers in quitting than the benefits of quitting. Nevertheless, our previous
smoking cessation interventions mostly focused on using brief interventions including
stage-matched smoking cessation advice. Such interventions could be too brief and inadequate
to make a great impact on such smokers. Moreover, the investigators found that using strong
warnings to communicate the risk of continued smoking might not be accepted by some of them.
Hence, the investigators need to develop and evaluate a more innovative intervention to
enhance the effectiveness in promoting smoking cessation for smokers with chronic diseases.
Most importantly, the new strategy should have a good potential implementation in many
clinical settings.
Smoking has been found to be associated with physical inactivity, unhealthy diet, and
drinking. The interrelationship of health behaviours suggests that there could be a higher
level of attribute that determines such behaviours together. Our previous studies showed that
people with a general intention to promote their health are more likely to engage in
desirable health-related lifestyle practices. In addition, research results showed that
people once engaged in any desirable health-related lifestyle practices would progressively
move to later stages of change for other health behaviours. Based on this concept, a general
health promotion approach will be used to motivate smokers with intention to promote health
to first engage in any desirable health-related lifestyle practices that are chosen by
individual smokers, such as regular physical activity and healthy diet. It is anticipated
that once they are engaged in any desirable health-related lifestyle practice they will
eventually be more motivated to quit smoking.