Abstract
This thesis addresses the urgent need to strengthen smoking cessation services in Chinese healthcare settings. Despite national tobacco control policies, hospital-based cessation support remains inconsistent and underdeveloped. This research explores how smoking cessation services can be effectively implemented and embedded within the hospital context in China.A mixed methods approach was adopted. Ethnographic fieldwork in a tertiary hospital explored contextual influences on smoking cessation practice, followed by qualitative interviews with healthcare professionals, patients, and family members to capture perspectives on cessation support. A national survey of healthcare professionals further examined current practices, attitudes to smoking cessation, and training needs. Findings from these three studies were triangulated to provide an integrated understanding of cessation implementation in the Chinese healthcare system.
The findings revealed that smoking cessation practice is hindered by limited training, low confidence among healthcare professionals, and a cultural tolerance of smoking as a social norm. Despite awareness of tobacco-related harms, cessation support is often perceived as a low clinical priority, with limited institutional structures or incentives to deliver it. However, opportunities exist to embed cessation more effectively through doctor-led advice, structured training for nurses, family involvement, and leveraging digital health tools such as WeChat based follow-up programmes.
This thesis makes three key contributions: (1) it identifies the contextual and cultural factors shaping cessation delivery in Chinese hospitals; (2) it outlines clear, evidence-based recommendations for developing hospital cessation services; and (3) it proposes feasible next steps, including a pilot intervention, implementing targeted training for healthcare professionals, and developing digital follow-up systems to sustain quit attempts.
By integrating qualitative and quantitative insights, this research informs future implementation strategies and provides a foundation for policy and practice to advance tobacco control and improve public health outcomes in China.
| Date of Award | 15 Nov 2025 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Rachael Murray (Supervisor), Manpreet Bains (Supervisor), Tom Lane (Supervisor), Richard Hubbard (Supervisor) & Lixian Jin (Supervisor) |