Background and challenges to implementation:
Tobacco use is a major risk factor for non-communicable diseases (NCD). Nurses are in a good position to provide smoking cessation interventions to reduce the smoking rate. However, the barrier of nurses' workload and lack of competency lead to limitation of patient accessibility to smoking cessation services. This training project for nurses aims to increase smoking cessation interventions as part of standard nursing practice of Thai nurses.

Intervention or response:
Project Activity consisted of:
1) providing funding to 10 hospitals to train nursing skills and implement smoking cessation guidelines at outpatient department,
2) providing knowledge and skill training about 5As mode,
3) allocating responsibility among nurses at the OPD and smoking cessation clinic,
4) creating a multidisciplinary team for providing smoking cessation treatment, and
5) recording screening and smoking cessation outcomes.

Results and lessons learnt:
The majority (90%) of 250 nurses who participated in the smoking cessation training were satisfied with and had positive attitudes for providing smoking cessation service in their routine work. After completing one year of the project, 1394 patients of general and NCD clinics were detected as current smokers, 33.7% of them were referred to smoking cessation clinics. The quitting rate at 6 months was 24.4 %. We found that enhancing nurses' knowledge and skills about smoking cessation and having a nurse-led smoking cessation clinic increase the rate of access to smoking cessation services and rate of quit smoking. Motivation skills to help patients stop smoking and improving the referral system to smoking cessation clinics are needed for increasing the quit rate.

Conclusions and key recommendations:
OPD Nurses can help NCD patients quit smoking as part of their routine work when they recognize the importance of their roles in smoking cessation and create a system to support their work.