Effectiveness of online training in improving primary care doctors' competency in brief tobacco interventions: A cluster-randomized controlled trial of WHO modules in Delta State, Nigeria

BACKGROUND

The World Health Organization (WHO) strongly recommends that brief tobacco interventions should be routinely offered in primary care. However, medical doctors do not consistently and effectively intervene during their encounters with cigarette smokers. There is a paucity of studies assessing the effect of training on the tobacco intervention competency of primary care doctors in Nigeria.

AIM

To evaluate the effectiveness of online training in improving competency in brief tobacco interventions among primary care doctors in Delta State, Nigeria.

METHODS

A cluster-randomized controlled trial was conducted among eligible doctors working in government-owned facilities. The 22 eligible Local Government Areas (LGAs) served as clusters. The intervention group received a WHO six-hour online course on brief tobacco cessation intervention, delivered via Zoom. The control group received no intervention. A structured questionnaire was sent to participants via WhatsApp before and six months after the training. The primary outcome variables were scores for knowledge, attitude, self-efficacy, and practice. Differences in change of scores between intervention and control groups were assessed with t-test. To adjust for clustering, these inter-group differences were further analyzed using linear mixed-effects regression modeling with study condition modeled as a fixed effect, and LGA of practice entered as a random effect.

RESULTS

The intervention group had a significantly higher mean of change in scores for knowledge (effect size 0.344) and confidence (effect size 0.52).

CONCLUSION

The study shows that training, even online, positively affects clinician competency in brief tobacco intervention. This is important for primary care systems in developing countries. Mandatory in-service training and promotion of the WHO modules are recommended.

Highs and downs: A scoping review of public opinion about cannabis, alcohol and tobacco in Canada

ISSUES

Since the legalisation of cannabis in October 2018, Canada has emerged as a privileged place for research on the properties of this substance, its health effects, but also on its relation with public opinion. However, this scoping review points out the complexity of tracing the evolution of Canadian public opinion on cannabis based on available scientific data.

APPROACH

This review follows the guidelines of the Joanna Briggs Institute and summarises more than 60 years of research on Canadians' public opinion, perception and knowledge of cannabis. The study also includes alcohol and tobacco in order to provide a meaningful comparison between substances.

KEY FINDINGS

One hundred and sixty-one references selected from over 30 000 studies, with the oldest dating back to 1956, show that public opinion on cannabis is under-studied in Canada compared to alcohol and tobacco. Young people and students are among the most studied populations, unlike Aboriginal communities, immigrants and elderly people. The study reveals the absence of experts in public opinion and political communication, and calls for an imperative need for theoretical frameworks rooted in the work of social scientists.

IMPLICATION

These findings do not suggest slowing the rate of publication on alcohol, tobacco, youth or students. Rather, they encourage increasing the rate of publication on other substances used and on other groups also targeted as being particularly at risk of misuse.

CONCLUSION

New studies need to measure and contribute to the understanding of Canadian public opinion on cannabis in comparison with public policies currently in place.

Developing Competency-Based Nursing Treatment for Persons With Tobacco Use Disorder

BACKGROUND

Tobacco continues to have a deleterious impact on health outcomes in the United States. Professional nurses at all levels of practice have an opportunity to be a part of the solution. The development of nurse-specific competencies for treating tobacco use disorder (TUD) disorder is long overdue. A task force of American Psychiatric Nurses Association (APNA) subject matter experts was assembled to engage in the process of reviewing the available peer-reviewed literature and additional evidence-based resources (e.g., professional organization position statement, toolkits, national survey results) to create the Nursing Competencies for Treating Tobacco Use Disorders.

OBJECTIVE

The aim of this article is ultimately to improve patient access to quality, evidence-based TUD nursing care by all nurses who are competent, full partners in TUD multidisciplinary care.

METHOD

Search terms were defined and a scoping search and review of the TUD literature and resources was performed from November 2018 to November 2020.

RESULTS

Over 300 articles and evidence-based resources (e.g., professional organization position statements, toolkits, etc.) were discovered. Thirteen competencies were developed and were internally and externally reviewed prior to APNA Board of Director's approval.

CONCLUSION

TUD competencies have the potential to guide nursing education, practice, and research, allowing nurses to be full partners in the design, development, and implementation of effective TUD treatment.

Knowledge, Attitudes, and Training in Tobacco Dependence and Cessation Treatment Among Nursing Students in Catalonia (ECTEC Study): Cross-Sectional Study

Nursing students are part of the future health labor force; thus, knowing their knowledge and participation in tobacco control is of importance. Multicentre cross-sectional study conducted to assess nursing students' knowledge, attitudes, and training in tobacco dependence and treatment at 15 nursing schools in Catalonia. We employed a self-administered questionnaire. 4,381 students participated. Few respondents (21.1%) knew how to assess smokers' nicotine dependence, and less than half (41.4%) knew about the smoking cessation therapies. Most (80%) had been educated on the health risks of smoking, 50% about the reasons why people smoke and, one third on how to provide cessation aid. Students in the last years of training were more likely to have received these two contents. Nursing students lack sufficient knowledge to assess and treat tobacco dependence and are rarely trained in such subjects. Nursing curricula in tobacco dependence and treatment should be strengthened to tackle the first preventable cause of disease worldwide.

Smoking cessation support: Indian nursing students' practices, attitudes and perceived barriers

BACKGROUND

Tobacco use is a significant global health issue. Studies that examined nursing students' attitudes towards smoking cessation support were limited from India.

AIM

To assess undergraduate nursing students' practices, beliefs, attitudes and perceived barriers towards smoking cessation support.

METHODS

A cross-sectional descriptive design was adopted among undergraduate nursing students (n=178) using self-reported questionnaires.

RESULTS

Findings revealed that a majority (68.5%) of the students inquire about their clients' smoking habits and 78.1% of them advise patients who are smokers about the health effects of smoking. Although student nurses hold positive attitudes in the enthusiasm domain (28.8 ± 7.29), the majority of them lack self-efficacy towards smoking cessation support (14.2 ± 4.70). 'Patient's lack of motivation' (89.3%), 'lack of training/knowledge' (88.2%) and 'lack of communication skills' (77.5%) were the major barriers encountered by the participants during tobacco counselling.

CONCLUSION

The findings suggest that there is an urgent need to include a tobacco-control curriculum at undergraduate level to improve their competency in giving smoking cessation support.

[Do we teach the smoking cessation intervention to future nurses? Result of a descriptive study]

Introduction :

Les infirmières qui ont reçu une formation en cessation tabagique ont tendance à intervenir davantage auprès des fumeurs que celles qui n’ont pas été formées. Il est démontré qu’une intervention même très brève conduit à une diminution de la prévalence du tabagisme. Or, les programmes qui préparent à l’exercice de la profession infirmière laissent actuellement peu de place à la formation en cessation tabagique. Les objectifs de la recherche sont de décrire les pratiques d’enseignement de la cessation tabagique dans les programmes de formation infirmière et de comparer en tenant compte de la formation en cessation tabagique reçue par les professeures.

Méthodologie :

Un devis descriptif-comparatif a été choisi.

Résultats :

Au total, 278 professeures (20,8 %) ont répondu à un sondage en ligne effectué à l’aide d’un questionnaire validé. Celles-ci avouent offrir en moyenne une heure en cessation tabagique par année. Les aspects physiopathologiques sont couverts au détriment de l’intervention professionnelle en cessation tabagique. Les obstacles identifiés par les professeures sont le manque de temps, de connaissances et de pertinence avec le cours enseigné. Seulement 11,9 % des sujets mentionnent avoir reçu une formation spécifique en cessation tabagique. Or ce sont ces dernières qui enseignent davantage d’éléments reliés à l’intervention en cessation tabagique.

Conclusion :

Une meilleure intégration de l’intervention en promotion de la santé, incluant la cessation tabagique, dans la formation initiale devrait amener la future infirmière à réaliser davantage d’interventions personnalisées en cessation tabagique.