World Health Organization Collaborating Centre for Smoking Cessation and Treatment of Tobacco Dependence
Best Practices of Smoking Cessation in the Western Pacific Region
Questionnaire
1. Country / Region
Macao
Programme background
2. Name of Programme / Service
Smoking cessation consultation in primary care
3. Objective(s) of the programme / service (e.g. triggering quit attempt, promoting new activity, provision of cessation services)
To help the smokers to quit the addiction of smoking
4. Duration / time period of the programme / service
Smoking cessation ultimately depends on the individual's willingness to quit. According to the World Health Organization, successful cessation is defined as abstaining from smoking for at least 26 weeks. While this is considered the ideal benchmark, some patients may require extended support beyond this period.
5. Target population
Although the program is available to the entire population of Macao, only local residents receive the service free of charge. As a result, participation among foreign workers who smoke is relatively low.
Programme details
6. Please briefly describe the activity(-ies) carried out under the programme / service (e.g. provision of smoking cessation services, campaign to promote/enhance cessation services provision).
Our physician make most of every opportunity to refer smokers to smoking cessation services.
7. What were the factors that contributed to the programme / service establishment?
Tobacco is the leading cause of preventable death worldwide, claiming millions of lives each year.
8. Did the programme / service involve other organisation(s) (e.g. non-governmental organisation, professional association, academia)? What were their roles?
The most prominent non-governmental organization for smoking cessation, the Au Hong Sam Smoking Cessation Association, unfortunately closed due to the COVID-19 pandemic and insufficient government funding. There was a university in Macao in its early stages of establishing an addiction treatment center. Kiang Wu Hospital also provides smoking cessation consultations, but their high fees have limited the number of clients.
9. Please briefly describe the resource implications for this programme / service:
| i. | How was / were necessary funding and / or manpower secured? |
|---|---|
| As a public service, funding is provided by the government, which is primarily sourced from casino revenues. | |
| ii. | Please briefly describe any use of information technology to implement or facilitate the programme / service |
| Personal dialogue is the most effective way to communicate with patients. Telephone calls are especially important when a patient misses a consultation or needs follow-up for a potential relapse. Additionally, sending reminder messages helps ensure they attend scheduled appointments. | |
| iii. | Any other special resource required to implement the programme / service? |
| A few months ago, we launched a website where smokers can access information about the benefits of quitting and book appointments for smoking cessation support. |
10. COVID-19
| i. | Please briefly describe any difficulties encountered during the programme / service implementation amid COVID-19. |
|---|---|
| Due to a shortage of staff in Macao's healthcare system during the COVID-19 outbreak, smoking cessation consultations were suspended as doctors and nurses were reassigned to epidemic control efforts. | |
| ii. | How did you overcome them? |
| Several external factors have supported tobacco control efforts. For example, mandatory mask-wearing and restrictions on public gatherings during the pandemic reduced opportunities for smoking in public. Additionally, border closures made it more difficult to smuggle tobacco products into the region. |
Programme evaluation
11. Was there any evaluation of the programme / service (e.g. quantitative survey, qualitative interview, etc.) conducted?
As shown in the presentation, the annual smoking cessation success rate increased significantly—from 21% in 2012 to 71.5% in 2021—partly influenced by the COVID-19 pandemic.
12. What was the impact of the programme / services (e.g. number of smokers who quit)?
Although the success rate of smoking cessation appears to be quite acceptable, the relapse rate remains high. The number of individuals seeking to quit largely depends on government policies—such as increasing tobacco taxes and restricting designated smoking areas—which can significantly influence motivation and behavior.
13. How would the evaluation results be used (e.g. improving policy / programmes)?
Smoking cessation should not be confined to primary care settings. For instance, hospitalized patients who smoke should begin cessation support immediately upon admission.