Skip to main content
Download PDF

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

Tobacco Induced Diseases volume 13, Article number: 10 (2015) Cite this article

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.

Background

China is the world’s largest producer and consumer of tobacco with 350 million smokers [1]. China has 740 million non-smokers passively exposed to SHS, including 180 million children under the age of 15 [2,3]. At present, an estimated 1 million deaths from smoking occur in China each year, and if the current smoking rates continue, as many as 100 million people currently under the age of 30 in China will die from tobacco use [1,2]. Thus, it is clear that tobacco control efforts in China must be intensified to combat the tobacco-induced morbidity and mortality.

Smoking cessation is a priority for preventing smoking-attributable disease and reducing its burden [4,5]. However, promotion of smoking cessation counseling and cessation medications by physicians is an obstacle for China [6]. Among the physicians group, pediatricians who can address both secondhand smoke (SHS) exposure to children as well as parental smoking cessation are in a critical position. Because, the SHS exposure to children due to parental tobacco use is a serious and prevalent health issue, with over twenty-four percent of children living in a home with a smoking parent [7]. Parental smokers often see their child’s doctor more frequently than their own, with an average of over 10 visits in the first two years of a child’s life [8,9]. However, very small proportions of pediatrician’s visits by a smoker result in cessation counseling or prescription for an effective smoking cessation medication [10]. It was argued that physicians are more likely to recommend treatments that they believe are effective [11]. In studies among physicians in overseas, belief regarding the effectiveness of counseling and cessation medications varied [12-14] with a substantial proportion holding misconceptions about the intervention effectiveness [13,14]. An exploratory study among Chinese pediatricians also reported misconceptions about the effectiveness of counseling and medications for smoking cessation [15]. Therefore, it is critical that the Chinese pediatrician’s beliefs are appropriate and evidence-based as they play a key role in clinical decision making. This study describes the beliefs of a sample of Chinese pediatricians regarding the effectiveness of counseling and medication for tobacco dependency treatment.

Methods

Sample

Participants were pediatricians working in the conveniently selected thirteen hospitals (twelve grade III and one grade I) in four major cities of Guangxi province (a Southern Chinese province), the People’s Republic of China.

Data collection

A standardized Mandarin Chinese language questionnaire was used for data collection. Questionnaires were distributed through the director of pediatrics department in each of the participating hospitals. The director distributed a copy of the questionnaire to each pediatrician working in his or her department and requested them to put the completed questionnaire in a sealed envelope and drop the questionnaire in the designated box kept in the doctor’s office. Our study coordinator then collected the sealed questionnaire from each of the directors. For clarity on any unfinished questions, our study coordinator contacted the individual pediatrician by telephone. To compensate for their time, each participant was given a cash amount of RMB 100 ($15). The study was approved by the institutional review board of Guangxi Medical University.

Questionnaire

The questionnaire was developed with reference to the questionnaires previously used by the investigators team in the United States [9] and in China [6]. The questionnaire obtained demographic information on the subject’s demographic background (sex, age, physician type, number of years studied at medical school), smoking behavior (smoker, non-smoker) and other questions on “counseling practices for smoking cessation and secondhand smoke (SHS) exposure to children”, “perceiving barriers for smoking cessation service”, “whether their workplace is smoke-free”, “whether they received any training on smoking cessation counseling”, which should be answered “yes” or “no”.

Belief of effectiveness for smoking cessation counseling was assessed by asking “physician counseling about smoking cessation is a cost-effective intervention compared to other preventive interventions?”, with response categories of “strongly agree, agree, disagree and strongly disagree”. Belief of effectiveness for pharmacological products was assessed by asking, “pharmacological products or medications (i.e., nicotine patch, nicotine gum, nicotine lozenges, bupropion, varenicline) are effective in helping smokers quit smoking”, with response categories of “strongly agree, agree, disagree and strongly disagree”. And responses were categorized as 1 for “strongly agree and agree”, 2 for “disagree and strongly disagree”.

Analyses

Two members of the research team coded each questionnaire and entered all data with Epidata 3.1, and then made a data consistency check. We used χ 2 procedures to compare differences between the belief of effectiveness and demographic characteristics or other relevant variables, and then used multinomial logistic regression analysis to analyze the factors with p-value <0.2 in χ 2 procedures. A p-value of <0.05 (two-tailed) was considered statistically significant.

Results

Demographic and other characteristics

A total of 550 questionnaires were handed out and 504 pediatricians completed the questionnaires, with a response rate of 92% (504/550). Response rates were almost identical in all the hospitals. Of the respondents, 64% were female, 77% received 5 years of education at medical school and 17% were current smokers (Table 1). More than one-third of the respondents didn’t hear about e-cigarettes. As a non-smoker, 46% of all pediatricians inhaled secondhand smoke for more than 15 minutes daily for more than 1 day during the past week; 81% of the samples didn’t receive formal training in smoking cessation and 64% of all pediatricians didn’t read China smoking cessation guidelines. Of the respondents, 60% and 53% believed that physician counseling and pharmacological products are effective for smoking cessation, respectively.

Table 1 Demographic and other characteristics of survey sample, Guangxi, China 2013 (n = 504)
Full size table

The belief that physician counseling is effective for smoking cessation

Table 2 describes the pediatrician’s beliefs regarding effectiveness of smoking cessation counseling. A significantly higher proportion of female (64%) than male (54%) pediatricians believed that cessation counseling is effective (p < .05). A higher proportion of pediatricians who reported that their hospital have a policy to advise smokers to quit smoking (64%) than those which have no policy (55%) believed that cessation counseling were effective (p < .05). Pediatricians who received formal training in smoking cessation (71%) than those who did not receive training (58%) believed that cessation counseling were effective (p < .02). A significantly higher proportion of those who had read China smoking cessation guidelines (66%) than those who did not hear about the guidelines (49%) believed that cessation counseling is effective (p < .05). Other significant characteristics related to the belief that cessation counseling is effective included being confident (65%) than not at all confident (32%) in discussing smoking or SHS exposure reduction with parents, believing that pediatricians can help parents stop smoking (77%) than not believing so (40%), in the usual practice advising (64%) than not advising (17%) parents not to smoke around children, agreeing (65%) than not agreeing (37%) with the statements that health professionals should routinely ask about parents smoking habits, believing (69%) than not believing (27%) that health professionals should advise smoking parents to quit smoking, believing that they possess adequate knowledge (81%) than not believing so (56%) to help parents in quitting smoking, and those who could assess smokers different stages of readiness to quit (75%) than those who do not believe so (58%).

Table 2 Factors associated with the belief that physician counseling is effective for smoking cessation, Guangxi, China 2013
Full size table

Multinomial logistic regression analysis showed that “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” were the factors associated with the belief that physician counseling is effective for smoking cessation (see Table 3).

Table 3 Multinomial logistic regression analysis on factors associated with the belief that physician counseling is effective for smoking cessation
Full size table

The belief that pharmacological products are effective for smoking cessation

Table 4 describes that nine factors were associated with pediatrician’s beliefs regarding the effectiveness of pharmacological products for smoking cessation. These factors are: receiving (65%) than not receiving (50%) formal training in smoking cessation (p < .02), reading (66%) than not reading (53%) China smoking cessation guidelines (p < .01), being confident (55%) than not at all confident (38%) in discussing smoking or SHS exposure reduction with parents (p < .01), believing that pediatricians can help parents stop smoking (67%) than not believing so (35%) (p < .001), in the usual practice advising (55%) than not advising (23%) parents not to smoke around children (p < .001), agreeing (59%) than not agreeing (29%) with the statements that health professionals should routinely ask about parents smoking habits (p < .001), believing (61%) than not believing (24%) that health professionals should advise smoking parents to quit smoking (p < .001), believing that they possess adequate knowledge (74%) to help parents in quitting smoking than not believing so (48%) (p < .001), and those who could assess smokers different stages of readiness to quit (67%) than those who do not believe so (50%) (p < .01).

Table 4 Factors associated with the belief that pharmacological products are effective for smoking cessation, Guangxi, China 2013
Full size table

Multinomial logistic regression analysis showed that “being confident in discussing smoking cessation or SHS exposure reduction with patients’ parents”, “believing that pediatricians can help parents stop smoking”, “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” were the factors associated with the belief that pharmacological products are effective for smoking cessation (See Table 5).

Table 5 Multinomial logistic regression analysis on factors associated with the belief that pharmacological products are effective for smoking cessation
Full size table

Discussion

To the best of our knowledge, this is the first study of pediatrician beliefs regarding the effectiveness of counseling and pharmacological products for smoking cessation in a developing country and in China. In the current study, 79% pediatricians did not receive any formal training on tobacco control or smoking cessation, although 84% of the pediatricians were very or somewhat confident about discussing smoking cessation or SHS exposure reduction with children’s parents. Studies elsewhere reported low rates of implementation of effective SHS exposure reduction interventions on parents who smoke among the pediatricians [16-18]. In an earlier study among Chinese parents [10], few parents (8/33, 24%) had positive experiences about the way they have been asked about SHS exposure to the children or about parental smoking status, and rarely were told by their child’s pediatricians to quit smoking.

Our findings show that about half of the pediatricians did not believe the fact that smoking cessation counseling and medication are effective in promoting smoking cessation. Evidence suggests that counseling [19,20] and cessation medications [21-25] are effective for smoking cessation. Factors that were associated with pediatricians’ beliefs included individual characteristics (i.e. female gender, perceived knowledge), clinical practice (i.e. receiving cessation training, advising to quit) and health system (i.e. hospital policy to ask about smoking) related factors. However, many other factors could influence these beliefs among the pediatricians. An earlier survey in China showed that, through creating smoke-free hospital activities, the rate of often asking patients’ smoking status increased from 55.0% to 68.9%, the rate of often advising patients to quit smoking from 67.8% to 77.3% [26]. The same study also reported higher confidence to provide smoking cessation service among physicians who received training on tobacco use prevention and cessation [26].

The low perceived effectiveness of counseling and medications for smoking cessation among Chinese pediatricians are not supported by the current evidence which suggests that these are effective intervention strategies [27-29]. The scarcity of smoking cessation services within the Chinese hospitals and the unavailability of cessation medications contributed significantly to possessing such beliefs among the pediatricians. It may be the fact that pediatricians were reluctant to know more about the effectiveness of these intervention modalities (i.e. counseling and medication) as they will not utilize these in their clinical practice. If these modalities for smoking cessation are to be fully implemented within the healthcare system, physicians need to be trained and aware of their effectiveness. At the same time, the Chinese healthcare system needs to realize the need for smoking cessation services with provision for medications. In this study, receiving formal training in smoking cessation or reading China smoking cessation guidelines were associated with the belief that cessation counseling and pharmacological products were effective.

Limitations

Several factors may limit the generalizability of the findings. First, the sample may not be representative of the whole pediatric population in China. Second, although it is expected that the characteristics of pediatricians working in all the similar grade level hospitals would be similar, there may be regional variations. However, responses to key items did not differ as a function of hospital type or physician type so this is unlikely to have affected the results. Third, one might expect that attitudes would change over time as more information about the smoking cessation intervention was available in China since this study was conducted. A follow-up survey may examine the changes of beliefs over time.

Conclusion

The findings suggest that 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 regarding the effectiveness of cessation counseling and medications. Perceived effectiveness of cessation counseling and medication may affect pediatricians’ clinical practice and recommendations for tobacco use reduction and cessation. Therefore, training efforts are needed to influence pediatricians’ beliefs about the available evidence-based interventions (i.e., counseling and medications). At the same time, health system-level change to incorporate cessation service within the healthcare delivery system will increase pediatricians’ participation in the training, enhance their understanding about the evidence-based intervention available for smoking cessation and generate positive beliefs towards cessation counseling and medication.

References

  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.

    CAS  PubMed  Google Scholar 

  2. Center for Disease Prevention and Control. Chinese Ministry of Health: GATS china report. Beijing: China CDC; 2010.

    Google Scholar 

  3. Liu Y, Chen L. New medical data and leadership on tobacco control in China. Lancet. 2011;377:1218–20.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Google Scholar 

  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.

    PubMed Central  PubMed  Google Scholar 

  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.

    Google Scholar 

  8. Rowland D, Lyons B, Salganicoff A, Long P. A profile of the uninsured in America. Health Aff. 1994;13(2):283–7.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  19. Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2005;2, CD001292.

    PubMed  Google Scholar 

  20. Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2005;4, CD001007.

    Google Scholar 

  21. Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2008;1, CD000146.

    PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by a grant (principal investigator: Abu S. Abdullah) from the Flight Attendant Medical Research Institute, USA, to the American Academy of Pediatrics (AAP), Julius B. Richmond Center. We thank the pediatricians who gave their time to contribute to this study.

Author information

Authors and Affiliations

  1. School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China

    Kaiyong Huang, Haiying Huo, Li Yang & Zhiyong Zhang

  2. Global Health Program, Duke Kunshan University, Duke Avenue, Kunshan, Jiangsu, 215316, China

    Abu S Abdullah

  3. Duke Global Health Institute, Duke University, Durham, North Carolina, USA

    Abu S Abdullah

  4. Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA

    Abu S Abdullah

  5. Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, China

    Jing Liao & Guangmin Nong

  6. MGH Center for Child and Adolescent Health Research and Policy, Harvard Medical School, Boston, USA

    Jonathan P Winickoff

Authors
  1. Kaiyong Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abu S Abdullah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jing Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Haiying Huo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhiyong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jonathan P Winickoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Guangmin Nong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Abu S Abdullah or Guangmin Nong.

Additional information

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KH took part in designing the study, drafted the manuscript, carried out the acquisition, analysis and interpretation of the data. ASA conceptualized and designed the whole study, supervised and instructed data collection and analysis, reviewed and revised the manuscript. JL and HH coordinated and supervised data collection, carried out the initial analyses. LY and ZZ contributed to the overall design of the study, commented on the data collection instrument, critically reviewed the manuscript. JPW contributed to the overall design of the study, critically reviewed the manuscript. GN contributed to the overall design of the study and data interpretation. All authors read and approved the final manuscript.

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, K., Abdullah, A.S., Liao, J. et al. Chinese pediatrician beliefs about counseling and medications for parents who smoke: a survey in southern China. Tob. Induced Dis. 13, 10 (2015). https://doi.org/10.1186/s12971-015-0035-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12971-015-0035-x

Keywords

Tobacco Induced Diseases

ISSN: 1617-9625

Contact us