Brief Tobacco Cessation Counselling: Mini Train-the-trainers Program

Overview

Physicians play a critical role in reducing tobacco use by advising smoking patients to quit. After receiving such advice to quit smoking, patients were more likely to report trying to quit, quitting for at least 24 hours, making more quit attempts, and having more successful quitting outcomes compared with those who received no such advice. On the other hand, most physicians are not performing smoking cessation counselling, and miss the opportunities to advise patients to quit smoking. One of the common reasons is the lack of time. Physicians are busy and cannot afford even one minute to advice their patients to quit smoking. Other barriers include lack of training and experience, lack of knowledge and skills, no awareness about the benefits and effects of physicians' advice, no incentives and no support or requirement from hospital management that they have to do it. We designed a brief smoking cessation counselling model (AWARD) which takes only 10-20 seconds. We will train the physicians to perform the AWARD cessation counselling model in clinic, and encourage them to participate in our brief smoking cessation intervention project using the randomized controlled trail (RCT) design and to train more peer physicians to perform brief smoking cessation counseling. We propose to investigate the effect of the training program on physicians' knowledge of tobacco cessation, practice of performing cessation counselling, and attitudes toward tobacco control policies.

Participating hospitals/clinics will invite 100-120 internal medicine physicians to take part in the brief smoking counselling intervention project and participate in a half-day mini TTT training program. The training will cover the following topics: * Goal and the details of the brief smoking counselling intervention; * Objective of the mini TTT training program; * Tobacco epidemic and control measures in China and the world; * Physicians' role in tobacco control; * Health risks of smoking, secondhand smoke exposure; * WHO FCTC (Framework Convention on Tobacco Control) and the MPOWER measures; * Brief smoking cessation counselling (AWARD model), and counselling skill with practice; * Placebo counselling and counselling skill with practice. On the training day, the investigators will explain at the beginning of the workshop the purpose of the training, and the details of the brief smoking cessation intervention to all physicians who attend the training workshop. The investigators will explain that the participation is totally voluntary, and the participants will be invited to complete a paper-and-pencil survey before and right after the training workshop, perform smoking cessation counselling or placebo counselling among patients at their clinics, and complete online survey at 6- and 12-month follow-up. Agreement to participate in the training program will be considered as consent and participants are required to sign a written consent form. At the end of the workshop, participants should be confident to perform brief smoking cessation counselling and placebo counselling for patients. We hypothesize that the training program will increase the participants' knowledge level of smoking and secondhand smoke exposure and the important role of physicians in tobacco control, increase their skill and confidence of performing smoking cessation counselling, and generate stronger support for tobacco control policies.