Ahead of World No Tobacco Day, we interviewed Professor William Li,FAAN, to discuss his pioneering work in integrating behavioural science with modern technology to transform smoking cessation support. As a Top 2% Global Scientist (Stanford University) and leader at CUHK’s Nethersole School of Nursing, Professor Li has secured HK$42M+ in grants and published over 200 studies. His team develops innovative interventions—including instant messaging platforms like WhatsApp/WeChat and self-determination theory-based protocols—to empower nurses in delivering personalised cessation guidance. In this interview, he shared how these strategies address challenges in chronic smokers and strengthen nurses’ frontline impact, aligning with global efforts to reduce tobacco-related cancers and healthcare burdens.
Smoking and cancer
Cigarette smoking is the leading preventable cause of premature death and disease, accounting for 8 million deaths annually worldwide, including approximately 1.3 million deaths from exposure to second-hand smoke. Evidence indicates that smoking adversely affects nearly every organ in the body and is linked to various types of cancer. Conversely, quitting smoking can significantly reduce the risks of developing and dying from cancer. For example, the risk of death from lung cancer has been shown to decrease by 30%–50% within 10 years of quitting.
Despite clear evidence that smoking increases mortality, decreases treatment efficacy, and increases the risk of cancer recurrence and the development of new cancers, many cancer patients continue to smoke post-diagnosis. However, quitting smoking after a cancer diagnosis can delay disease progression, decrease treatment side effects, and improve prognosis and quality of life. Therefore, it is crucial for nurses to support cancer patients in quitting smoking to enhance their health.
What are the challenges ahead?
Quitting smoking is extremely difficult, with relapse common due to intolerable withdrawal symptoms. This is especially true among chronic smokers, who often have a long smoking history, high nicotine dependency, and low quit success rates. These individuals are often less responsive to current tobacco control interventions or policies and will ultimately constitute an increasing proportion of remaining smokers in the community. Overcoming this challenge will require innovative and effective smoking cessation strategies, along with tailored advice and support from healthcare professionals.
What can nurses do?
Healthcare professionals have a moral obligation to help smokers quit due to the detrimental effects of smoking on health. Nurses, as frontline clinical staff, spend more time with patients than other healthcare professionals and interact with them across various settings. They play a crucial role in smoking cessation programmes and are uniquely positioned to provide valuable information and encouragement.
However, nursing curricula worldwide often lack comprehensive training on smoking cessation. Additionally, busy schedules can make it difficult for nurses to assist smokers in quitting. Therefore, incorporating smoking cessation training into nursing curricula to empower future nurses to help smokers quit is crucial. Nurse researchers should focus on developing and evaluating effective and cost-efficient smoking cessation interventions.
Technological advancements, such as mobile health apps, web-based platforms, and chatbots, can offer improved solutions to the challenges faced by nurses in promoting smoking cessation. The application of artificial intelligence in healthcare can assist nurses in delivering continuous professional advice and personalised support. By leveraging these strategies, nurses can significantly reduce smoking rates and prevent cancer, ultimately improving public health outcomes globally.
In sum, nurses can play a pivotal role in helping smokers to quit, reducing tobacco-related illnesses and deaths, and improving quality of life. This also protects the public from exposure to second-hand smoke, fostering a healthier environment for future generations. Additionally, it can reduce the economic burden on the healthcare system imposed by smoking and the related diseases, especially cancer. These outcomes will guide smoking cessation policies and boost sustainable development.
The following illustrations depict key components of Prof. Li’s Self-Determination Theory-based interventions, integrating behavioral science to empower nurses in smoking cessation support.
