Training female doctors in China

China is the world’s largest consumer of tobacco with nearly 301 million smokers, including 52.9% of men and 2.4% of women [1]. Moreover, an estimated 740 million nonsmokers are exposed to secondhand smoke in China [1]. Secondhand smoke exposure is an important risk to the health of Chinese people, especially for women and children.

Although the percent of female smokers in China is small (2.4%), there were more than 10 million female smokers in China, and the number is increasing. Helping female smokers quit will be very important in tobacco control in China.

The good news is the number of Chinese doctors committed to helping smokers quit is increasing, and most of them are female doctors. The WHO Collaborating Center set up the first smoking cessation clinic in China at Beijing Chao-Yang Hospital in 1996, where all of the doctors were female. The WHO Collaborating Center also built up the first quitline in China in 2004 and updated this quitline to a national quitline in 2009. All of the quitline counselors were female.

Moreover, in collaboration with the Nicotine Dependence Center of Mayo Clinic, the World Health Organization Collaborating Center for Tobacco or Health held three National Nicotine Dependence Conferences in 2006, 2007 and 2009, and more than 400 medical professionals around China attended these conferences.

The Center developed the first China Clinical Smoking Cessation Guideline in 2007 and updated it in 2009. To improve the knowledge and skill of smoking cessation practices among Chinese physicians, the WHO Collaborating Center carried out a smoking cessation training course for doctors supported by the Ministry of Health and World Health Organization from 2010[2]. This was based on the UK Smoking Cessation Training Program for a three-day course and material covered in the National Health Service Centre for Smoking Cessation and Training Stage[3]. It also included sessions addressing issues specific for China. Training on how to deal with typical and difficult situations in the process of providing cessation services, how to overcome barriers to effective use of smoking cessation medications, and how to solve some practical issues in running a smokers clinic in China was provided.

From 2010 to 2012, Ninety-nine physicians took part in the training course. Among of those participants, 54 (54.5%) were female physicians, and came from 46 hospitals in 33 cities representing 22 provinces and 5 autonomous regions. Participants’ knowledge, skills and self-efficacy across different domains significantly improved after the three-day training course. Sixty-eight participants received certification as a “smoking cessation specialist”, including 46 female physicians (67.6%).

All of the participants (100%) found the course as a whole as well as the presentations and practical exercises useful or very useful. After the trainings, the female physicians became more committed to tobacco control in their hospitals. They disseminate information about the health hazards of smoking and secondhand smoke, especially to women and parents, and help the smokers quit and nonsmokers (especially women and children) abstain from secondhand smoke.

In their efforts, at least 35 hospitals have established smoking cessation clinics, and these clinics run well.

Evidence-based clinical interventions for smoking cessation are effective in reducing smoking rates among patients who use tobacco[4]. The new course was developed to disseminate such interventions in China where up to now such resources were lacking. Having evidence that such courses can meet their objectives, at least in the short term, provides an important reassurance and encouragement for such work. Rolling out training for health care professionals on smoking cessation will be essential if China is to cater to the large number of patients who can benefit from smoking cessation treatments.

Dan Xiao is with the WHO Collaborating Center for Tobacco or Health, Beijing Institute of Respiratory Medicine, Beijing, China. She is the director of the tobacco dependence treatment clinic at Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Shuilian Chu is with the WHO Collaborating Center for Tobacco or Health, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital and Department of Respiratory, Capital Medical University, Beijing, China.

About the Author: Chen Wang is with the WHO Collaborating Center for Tobacco or Health, Research Centre of Respiratory Medicine in Beijing Hospital, Ministry of Health of the People’s Republic of China , Beijing, China and the Department of Respiratory, Capital Medical University, Beijing, China.

  1. Li Q, Hsia J, Yang G. Prevalence of smoking in China in 2010. N Engl J Med 2011, 364: 2469-2470.
  2. Zhang CM, Xiao D, West R, Michie S, Troughton R, Hajek P, Wang C. Evaluation of 3-day smoking cessation training course for doctors from 38 cities in China. Chin Med J (Engl). 2012, 125: 1338-40.
  3. UK National Health Service Center for Smoking Cessation and Training. NCSCT Stage 1 Training & Assessment Programme (knowledge). (Accessed January 30, 2012 at
  4. The 2008 PHS Guideline Update Panel, Liaisons, and staff. Treating tobacco use and dependence: 2008 update. Rockville, MD: US Department of Health and Human Services; 2008. 39-60. (Accessed January 30, 2012 at