Table 2: Areas of deficiencies and implemented strategies
Areas of deficiencies
Implemented strategies
Policy    
  Lack of comprehensive preventive programme   Formation of Health Promotion Working Group
      Collaboration with Tobacco Control Office of Department of Health
       
Practice    
  Lack of guideline or protocol   Adoption of the smoking cessation guideline24
      Implementation of Nicotine Replacement Therapy programme25
       
  Lack of reminder system   Set up of reminder system
     
  • Chart reminder on the cover page
  • Smoking status insert in medical record*
  • Computerized smoking registry#
       
  Lack of appointment and follow up system
Lack of resources (Time, place, nicotine replacement therapy)
Lack of evaluation		   System change
   
  • Establishment of smoking cessation clinic
  • Designated area for smoking cessation with telephone
    hotline
  • Regular evaluation activity
       
Staff    
  Lack of team work   Team change
     
  • Formation of smoking cessation team
  Lack of continuous education and training on smoking cessation   Improvement in education and training in quitting smoking via training workshop/seminar
  Ineffective use of available resources   Centralized storage and distribution of available resources
       
Patient    
  Lack of awareness and motivation   Clinic activities
     
  • Video show
  • Exhibition of smoke free message
  • Smoke free week
* Smoking status insert
It was attached to medical record of every smoker attending the clinic. It encompassed checklist for all the four audit criteria. The information would be reviewed at least annually.
# Computerized smoking registry
It included patient𠏋 identity card number, gender, date of birth, date of registry, age of first smoking, type of smoking, number of cigarettes taken per day and checklist for all the four audit criteria. The data were reviewed at least annually.