Introduction:
Smokers with non-communicable diseases (NCDs) admitted to hospitals represent an excellent teachable moment for smoking cessation, as they are required to abstain from tobacco use during hospitalisation. Nevertheless, behaviours of smokers with NCDs, and factors that lead to smoking abstinence thereafter, remain relatively underexplored.

Objectives:
This study aimed at understanding the risk perceptions, behaviour, attitudes and experiences related to Chinese smokers with NCDs, and exploring factors leading to their abstaining from cigarette use.

Methods:
In the first phase of the study, a phenomenological research design was used to develop an understanding of the needs and concerns of 30 Chinese hospitalized smokers with NCDs, including their behaviour, attitudes, risk perceptions and experiences related to smoking and smoking cessation. In the second phase, a retrospective cross-sectional study was conducted in three outpatient clinics in different regions in Hong Kong. A total of 382 Chinese smokers with NCDs were recruited.

Results:
In the first phase of the study, four themes were generated: 1) associations between perception of illness and smoking; 2) perceived support from healthcare professionals to quit smoking; 3) impact of hospitalization on behaviour, attitudes, and experiences; and 4) perceived barriers to quitting smoking. For the second phase of the study, the results indicated 23.6% of smokers smoked secretly during their hospital stay, and about 76.1% of smokers resumed smoking after discharge. Multivariate logistic regression analysis found that number of days of hospitalisation admission in the preceding year, patients’ perceived correlation between smoking and their illness, withdrawal symptoms experienced during hospitalisation and smoking cessation support from healthcare professionals were significant predictor of smoking abstinence after discharge.

Conclusion(s):
This is the first study to investigate the smoking behaviours of smokers with NCDs. The results indicated the importance of developing an intervention that helps smokers with NCDs demystify misconceptions about smoking so as to achieve more successful smoking abstinence.