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The health care system in Hong Kong has historically been steeped in the biomedical paradigm. Health care reform, however, is finally putting health promotion on the agenda of governments and health care providers. As the largest group of providers in Hong Kong, nurses must assume a leadership role in the transition of the current illness-focused system to one that emphasizes health and promotes wellness. For nurses to take up the challenge of health promotion, they need to acquire the requisite knowledge and skills. Nursing curricula must emphasize this new paradigm and provide opportunities for students to develop expertise in health promotion and disease prevention. This article describes a health-promotion initiative carried out by 1st-year students in an undergraduate nursing program in Hong Kong. The health-promotion project aims to prepare graduates who will be able to meet health care needs and function effectively in the future health care system. Not only will these nurses be capable of becoming future leaders of the health-promotion movement in Hong Kong, they are also contributing to the health and wellness of Hong Kong citizens. ; published_or_final_version

SRNT, Poster Session 1, abstract no. POS1-55 ; Background: The Hong Kong Government implemented a comprehensive smokefree legislation on 1 January 2007, which restricts smoking in indoor workplaces, restaurants, karaokes, public places/park, beaches, and school (both indoor and outdoor). This study aims to examine the perceived self-efficacy to quit smoking of smokers from two study samples after the smoke-free legislation. Method: Two cross-sectional samples were recruited. The first sample was Chinese youth smokers, aged 12-25, who called the Youth Quitline and received smoking cessation counseling. The second sample was Chinese smoking fathers living with non-smoking mother and a child aged ≤12 years old. We conducted a telephone survey in the two samples, consisted of 4 items on perceived impact of the legislation on self-efficacy to quit smoking and compared the proportions of smoking participants in the two studies by chi-square tests. Results: A total of 288 youth smokers and 608 smoking fathers completed the questionnaires. 75% of the youth smokers were male, 67% were students, a mean age of 17 years, and 62% had mild nicotine dependency. The smoking fathers' mean age was 39.3 years, 75.1% had secondary education, 95.4% were currently employed, and 62% had mild nicotine dependency. In both samples, about one-third had increased in their motivation to quit smoking (youths vs. fathers) (37% vs. 26%), perceived importance in successful quitting (32% vs. 25%), confidence in quitting (28% vs. 18%); and fewer had perceived difficulty in quitting (11% vs. 6%). While the majority (>60%) remained no change, significant differences were observed in all the 4 variables between the two samples after the legislation (p < 0.001). Conclusion: Although majority of the smoking fathers and youth smokers had little/no change after the legislation, more subjects reported an increase in motivation and confidence to quitting, suggesting the need for more effort from the government to promote smoking cessation. More youth smokers than smoking fathers showed positive changes indicating youth smokers are sensitive to the enactment of the legislation and changes in the overall environment, compared to adult smokers.

Conference Theme: Tobacco and Non-Communicable Diseases ; Poster Discussion 60. Making Smokefree the Norm in Challenging places: no. PD-1301-21 ; BACKGROUND: Implementation of comprehensive smoke-free legislation in Hong Kong banning smoking in most public places may not protect children from secondhand smoke (SHS) exposure at home. This study compared the cotinine levels of children in smoking households with and without SHS avoidance practices. DESIGN/METHODS: The data was collected from mothers and children recruited from 4 Maternal and Child Health … ; published_or_final_version

Parallel Session II: Prevention of Non-communicable Diseases ; Since the enforcement of the smokefree legislation in 2007, more smokers have been gathering near some public rubbish bins at outdoor bus stops, outside office buildings and shopping malls to smoke. These "hotspots" provided an opportunity of publicizing and providing smoking cessation services to a large number of smokers and motivate them to quit. We aimed to promote smoking cessation at smoking hotspots and evaluate the feasibility and effectiveness of a pilot outreach approach. Out of the 26 smoking hotspots near shopping malls and commercial buildings, 10 hotspots with the great number of smokers were selected for the intervention from February to August 2009. Trained smoking cessation counsellors disseminated 2-page promotional leaflets and proactively delivered brief smoking cessation counselling (less than 5 minutes for each smoker) to smokers for 4 hours at each hotspot. We evaluated the programme by counting of smokers non-smokers 1 week before and 1 week after the intervention. We observed the smokers' responses and behaviours when they were approached by the counsellors. In the observed 1,237 smokers at the 10 hotspots, the counsellors approached 751 (60.7%) smokers. 419 (55.8%) read or kept the promotional leaflets. 413 (55.0%) were willing to receive the brief on-site counselling. The intervention reduced the number of smokers at the hotspots by 7.8% (pre: 1,251, post: 1,154)) with 2.1% increase in non-smokers (pre: 5,004, post: 5,108). The proportion of smokers at hotspots reduced by 1.6% (95%CI 0.04%-3.1%, p=0.053) comparing 1 week before and after the intervention, whereas there was no significant difference in non-smokers (risk difference=1.6%, 95%CI -1.6%-4.7%, p=0.40). The outreach programme had a slightly positive impact to reduce the proportion of smokers at hotspots. The smoking hotpots are good locations for feasible and effective delivery of smoking cessation messages. Improvement in the approaching skills and incentives are needed. ; postprint

The World Congress of Cardiology: Scientific Sessions 2010. Beijing, China, 16-19 June, 2010 ; published_or_final_version

Paper Session 15 - The Challenge of Second-Hand Smoke: PA15-3 ; BACKGROUND: After the Smoking Ordinance enacted in HK since 1/2007, shifting of smoking from outdoor to home was found, home becomes a major source of secondhand smoke (SHS) exposure of nonsmokers. OBJECTIVES: It aimed to assess the SHS exposure of babies and mothers living with smoking fathers of two housing types by using a biomarker. METHODS: Trios of smoking father, non-smoking mother and a baby under 18-months were recruited from Maternal and Child Health Centres (MCHCs) from 6/2008 to 10/2009. Consented couples completed the baseline survey including demographic data, fathers' household smoking behaviors and mothers' actions in protecting babies from household SHS exposure. Saliva samples from baby and mother were collected and then sent to the National University of Singapore for cotinine analyses. Log-transformations were used for the saliva cotinine due to skewed data. There were 2 housing types (public/private) and father was asked if they smoked at home (yes/no). MANOVA was used to compare the babies' and mothers' cotinine levels when fathers smoked at home under the 2 housing types. RESULTS: 1,158 trios were consented. 1,142 mothers' and 1,058 babies' samples were assayed. The mean age of the fathers and mothers was 35.5(±7.0) and 31.2(±4.9). The mean mothers' cotinine level was 12.15ng/ml (±61.20) while babies' was 2.38ng/ml (±6.01). 606 and 501 trios were living in public and private housing. Fathers' smoked at home led to higher mothers' and babies' saliva cotininary (mean log of mothers' cotininary: 0.14±0.62 vs. 0.05±0.55, p=0.06; babies: 0.16±0.38 vs. 0.07±0.34, p=0.003). Housing types influenced babies' cotinine level (public: 0.17±0.37; private: 0.10±0.36, p=0.01). MANOVA showed that fathers smoked at home (Λ=0.99, p=0.01) and housing types (Λ=0.99, p=0.01) were positively related to the saliva cotinine levels. CONCLUSIONS: Father smoked at home and the housing types have greater impact on babies' saliva cotininary, showing that they were highly exposed at home and in public housing environment. HK government should promote smoke-free homes and to provide more smoking cessation services to minimize the household SHS exposure to babies ; published_or_final_version