Smoking cessation advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia

Client's perception toward services of smoking cessation clinics in Riyadh, Saudi Arabia

Background

In Saudi Arabia, approximately 70,000 deaths yearly occur from diseases caused by smoking. Assessing patients' smoking behavior in primary care has apparent benefits. Assisting patients with smoking cessation is one of the essential roles of primary care. This study evaluated the quality of smoking cessation clinic counseling in Riyadh, Saudi Arabia, based on customer opinions of such services.

Methods

This research employed a cross-sectional approach involving individuals attending smoking cessation clinics located within primary health care centers in Riyadh city. The participants were chosen through random selection. They were informed about the study's objectives, and those who consented to take part were contacted and provided with an online questionnaire to complete.

Results

A total of 340 subjects participated (95.6%) of them were males, and 41.2% were in the age group of 25 to 35 years old. The common modality of tobacco use was cigarettes (82.6%), and 87.9% reported consuming tobacco daily. The mean (±SD) total score of the Fagerstrom Test of Nicotine Dependence was 5.03 (±2.36), and the highest percentage (44.4%) of the participants had a moderate level of nicotine dependence. The vast majority (93.8%) of the participants had former quitting experiences. Half (50.9%) of the participants showed complete satisfaction with the cessation clinics, while 13.2% and 9.1% of them were not satisfied or slightly satisfied, respectively.

Conclusion

The majority of smoking cessation clinic visitors were satisfied with the services provided, exceeding three-quarters of them, with half totally satisfied.

Evaluation of smoking cessation counseling practices of physicians working in primary health care institutions

Background/aim

In this study, we aimed to evaluate the self-reported practice of physicians working in primary health care institutions in Elazığ Province about smoking cessation counseling.

Materials and methods

The population of this cross-sectional study consisted of 262 physicians working in primary health care institutions in Elazığ. We aimed to reach the entire population without using the sample selection method and we successfully reached 95.42% (250 people) of the population. A questionnaire form was used for data collection. The data obtained were evaluated by frequency, percentage, mean ± standard deviation, median and minimum-maximum, and binary logistic regression analysis.

Results

The mean age of the physicians was 40.86 ± 10.58 years and 68.0% of them were male. Among them, 30.4% (n = 76) were current smokers, 17.6% (n = 44) were former smokers and 52.0% (n = 130) were never smokers. The physicians' frequency of applying the steps of smoking cessation counseling was as follows: 38.8% "Ask", 81.6% "Advice", 68.4% "Assess", 66.8% "Assist", 31.2% "Arrange". Additionally, 16.0% of the physicians received smoking cessation counseling training. Those who had not smoked at least 100 cigarettes in their life applied the "Advice" (p = 0.026) step more frequently. Those who received smoking cessation counseling training applied the following steps more frequently: "Ask" (p = 0.024), "Assist" (p = 0.025), and "Arrange" (p = 0.001).

Conclusion

It is seen that the smoking frequency of primary care physicians in Elazığ Province is the same as that of the general population, and the frequency of smoking cessation counseling is far behind the target. Physician population is an important target group that should not be ignored in the fight against smoking. In order to increase the frequency of physicians' smoking cessation counseling practice, there is a need to increase the number of physicians who receive smoking cessation counseling training.

Knowledge, attitude and practice of smoking cessation counseling among dental hygienists in Saudi Arabia

INTRODUCTION

Tobacco has major effects on the oral health of an individual. Dental hygienists play an important role in smoking control by educating and motivating patients and community. The aim of this study is to add more evidence on knowledge, attitude, and practice of smoking cessation counseling among dental hygienists in Saudi Arabia.

METHODS

The study is a cross-sectional study, subjects are dental hygienist practitioners in Saudi Arabia employed in either public or private hospitals in 2021. The data collection tool of this study was a semi-structured self-administered questionnaire of 36 questions. The final sample included 80 employed participants.

RESULTS

Knowledge differed significantly amongst participants according to their educational level, with the highest mean knowledge scores among PhD versus Bachelor’s degree holders [mean (SD) = 27.7 (29.3) vs 21.9 (10.8), p=0.038, respectively]. On the other hand, dental hygienists attitude percentage scores differ statistically by working place; dental hygienists working in public health organization had a score [mean = 74 (8.9)] was higher compared to those in private health organizations [mean = 69.3 (10.8)]. Also, participants attitude percentage mean scores differ statistically by years of experience; the higher the years of experience the higher the dental hygienists’ adaptation of an attitude toward smoking cessation counselling. In terms of dental hygienists practice percentage mean scores, the only statistically significant difference was educational level [Bachelor’s: 64 (17.7); Master’s: 103.3 (17.2); PhD: 108.8 (15.3); p=0.003].

CONCLUSIONS

Dental hygiene practitioners’ level of knowledge is unsatisfactory. Workshops and program training are indeed necessary to increase dental hygiene knowledge leading to effective implementation of smoking cessation counselling.

Knowledge, Attitudes and Practices of Primary Care Physicians Regarding Tobacco Dependence Treatment in Muscat Governorate, Oman: A cross-sectional study

Objectives

This study aimed to assess the knowledge, attitudes and practices (KAPs) of primary care physicians (PCPs) regarding tobacco dependence treatment (TDT) and to identify barriers to TDT practice in Muscat, Oman.

Methods

This cross-sectional study was carried out from September 2019 to December 2019 at all 27 health centres in Muscat. All 313 PCPs working in these health centres were invited to participate. An adapted version of a previously validated 36-item questionnaire was used to assess KAPs regarding TDT services.

Results

A total of 255 PCPs completed the survey (response rate: 81.5%) and they demonstrated poor knowledge (40%) but positive attitudes (60%) about TDT services. Of these, the majority were female (85.9%), had never smoked (99.2%) and were general practitioners (64.3%). The mean age was 34.3 ± 6.3 years. Only 28.2% had previously received TDT training and less than half displayed accurate TDT-related knowledge, with undergraduate medical school representing the main source of such knowledge (58.8%). While 96.9% of the PCPs agreed on the importance of TDT, only 28.6% reported feeling sufficiently confident to provide such services themselves. Lack of training (83.5%) and time (71.4%) were the main barriers to TDT practice.

Conclusion

Overall, PCPs in Muscat demonstrated poor knowledge but positive attitudes with regard to TDT; however, further knowledge and training is required in order to ensure the effective and accurate provision of TDT services. These findings provide baseline data which may be of value for further research and in overcoming barriers to TDT practice in Oman; for instance, establishing cessation services as part of the package of care in primary health centres could address the time constraints barriers identified by the PCPs.

Determinants of smoking cessation counseling favorable practice for primary care physicians: A cross-sectional study from Palestine

Background:

Smoking cessation counseling is not well established in Middle East countries including Palestine. This study assesses the practice of smoking cessation counseling among primary healthcare (PHC) physicians in Palestine and its determinants.

Methods:

Over the period from April to September 2019, general practitioners, family medicine physicians, obstetricians and gynecologists, and dentists working at the PHC Centers in Palestine were approached through a cross-sectional design using a self-reported questionnaire. Proportionate stratified random sampling approach has been used. Sociodemographic, medical background, smoking cessation counseling training, smoking history, practice, knowledge, attitude, and confidence were evaluated. The proportion of favorable practice has been determined and its relationship with all variables has been evaluated. Ethical approval was received from the National University of An-Najah.

Results:

295 physicians were enrolled in the study with an 86% response rate. 75.5% (n = 222) were males with a mean age of 39.9 ± 9 years. The majority were General Practitioners (76.5%, n = 252). Most of them (84.3%, n = 215) had not received any training. The favorable practice was seen in 36.6% (95% CI 31–41%). Attitude is the main predictor of favorable practice (P value = 0.002, adjusted OR = 1.1).

Conclusion:

Palestinian PHC physicians have a low level of counseling for smoking cessation. Given the efficacy of counseling for smoking cessation and the high level of the tobacco epidemic in the area, health policy to ensure all healthcare personnel-especially physicians-receive training in cessation counseling and call for a public health campaign for control of tobacco should be taken into account.

Smokers' and Non-Smokers' Attitudes towards Smoking Cessation in Saudi Arabia: A Systematic Review

Literature on smoking in Saudi Arabia is extensive. However, studies capturing the attitudes of both smokers and non-smokers towards smoking cessation are few. A PRISMA-P protocol guided systematic searches in MEDLINE and CINAHL on MeSH terms (smoking cessation AND Saudi Arabia). Peer reviewed articles in English were included in the narrative analysis. Screening reduced the 152 articles identified to 15 and independent critical appraisal identified 10 final articles for review. Few adopted validated survey tools or mentioned the best practice to be followed. There was considerable variation in the prevalence of smoking reported (13.7–49.2%) and survey response rates (8.9–100%). There was a paucity of quality evidence but it is clear that the smoking pandemic is still resonant in Saudi Arabia. Despite support for education programs to prevent the uptake of smoking, policy-driven action to reduce environmental second-hand smoking, and provision of support for smoking cessation, more needs to be done.

Changes in Addressing Patients' Smoking: Cross-Sectional Data from 2002 and 2014 among Physicians in Estonia

Background:

For health professionals, personal and contextual factors influence addressing patients’ smoking habits. The objective of the study was to describe frequency of addressing patients’ smoking in 2002 and 2014 and to analyse factors related to addressing patients’ smoking habits.

Methods:

Data of physicians from 2 postal cross-sectional surveys were used (n = 4140 in 2002, n = 5666 in 2014). The number of respondents was 2747 in 2002 and 2903 in 2014. The corrected response rate was 67.8% and 53.1%, respectively. Age-standardized frequency of addressing patients’ smoking during the last 7 days was determined. Distribution of other variables along with confidence intervals (CI) was calculated. Logistic regression was used to analyse association of addressing patients’ smoking with attitudes and perceived barriers regarding addressing patients’ smoking and with background factors. Fully adjusted odds ratios (OR) with 95% CIs were calculated.

Results:

The age-standardized prevalence of addressing patients’ smoking habits among men was 84.4% (95% CI 80.3–88.5) in 2002 and 88.3% (95% CI (84.5–92.2) in 2014, among women 82.1% (95% CI 80.2–83.9) and 89.0% (95% CI 87.2–90.8), respectively. According to logistic regression analysis, in 2014, significantly more physicians agreed that it is doctors’ responsibility to convince people to stop smoking (among men, OR 2.32; 95% CI 1.19–4.54, among women OR 1.41; 95% CI 1.06–1.88), that smoking prevention should form part of health professionals’ training, that physicians should have smoking related hand-out materials, and that lack of time was a barrier to addressing patients’ smoking. Addressing patients’ smoking was significantly associated with attitudes and perceived barriers regarding addressing patients’ smoking, age, and other background factors (among women only).

Conclusions:

Addressing patients’ smoking habits was more common in 2014 than in 2002, but the change was significant among women only. Compared to 2002, in 2014 physicians’ attitudes regarding addressing patients’ smoking were more approving. Results of this study are useful for policymakers and institutions involved in organization and development of smoking prevention training and cessation services.

Smoking behavior of primary care physicians and its effect on their smoking counseling practice

Context:

Smoking among the primary care physicians (PCPs) is detrimental to not only their own health but it may also affect their attitude and practice towards smoking cessation counseling.

Aims:

We aimed to assess the smoking behavior of primary care physicians and its effect on their patient smoking counseling practices.

Subjects and Methods:

A cross-sectional study was conducted among the primary care physicians (N = 261) working under the Ministry of Health in Riyadh city, Saudi Arabia during May to June 2018. The data was collected using a self-administered questionnaire that was based on global adult tobacco survey. The participants were selected through simple random sampling.

Results:

About 16% of PCPs were found to be current smokers while about 9.6% were ex-smokers. On binomial logistic regression current smoking was observed to be independently associated with gender, specialty, and years of work experience (P < 0.01). The practice of smoking cessation advice was found to be significantly associated with physicians’ current smoking status after adjusting for other factors; PCPs who were non-smokers were 2.97 (95% CI 1.34-6.54) times more likely to always advice patients on cessation as compared to smoking colleagues.

Conclusions and Implications:

Smoking behavior of physicians was found to affect their patient smoking cessation counseling. This finding should be used in while planning and training staff for smoking cessation services in primary care settings.

The perceived effectiveness of MERS-CoV educational programs and knowledge transfer among primary healthcare workers: a cross-sectional survey

BACKGROUND

Knowledge transfer of Middle East respiratory syndrome coronavirus (MERS-CoV) involves the dissemination of created/acquired information on MERS-CoV in hospitals, making this information accessible to all healthcare workers (HCWs). This study evaluated the perceived effectiveness of MERS-CoV educational programs and knowledge transfer among primary care HCWs at a hospital in Saudi Arabia that witnessed the largest outbreak of confirmed MERS-CoV cases in this country.

METHODS

A survey was distributed among primary care HCWs at five clinics in Saudi Arabia in 2016. Those with non-direct patient care responsibilities were excluded. Their knowledge was evaluated against facts published by Mayo Clinic Foundation, and its percentage mean score (PMS) ± standard deviation was calculated. HCWs' perceived effectiveness of educational programs and knowledge transfer was classified as negative or positive.

RESULTS

Sample comprised of 404 HCWs, of which 64% were females and 36% were males. Almost 26% were ≤ 30 years old, and 42% had > 10 years of work experience. Almost 46.5% were nurses, 23.0% physicians, 18.1% were pharmacists, and 12.4% were technical staff. PMS for knowledge was 71.1 ± 19.4. The prevalence of negative perceptions towards educational programs was 22.5% and of knowledge transfer was 20.8%. Older(> 40 years of age) and more experienced(> 10 years) HCWs had the highest PMS for knowledge(73.4 ± 18.9,P = 0.005 and 76.9 ± 15.7,P < 0.001 respectively). Negative perceptions of educational programs (49.4 ± 20.7; P < 0.001) and knowledge transfer (46.0 ± 19.7; P = 0.001) were associated with a lower knowledge PMS. Males were 2.4[95% confidence interval 1.4-4.2] times and 2.0[1.1-3.5] times more likely to have negative perceptions of educational programs and knowledge transfer (adjusted (adj.)P = 0.001 and adj. P = 0.023, respectively). Physicians/pharmacists were 1.8[1.03-3.11] and 2.8[1.6-5.0] times more likely to have negative perceptions of both outcomes (adj. P = 0.038 and adj. P = 0.001, respectively). Less experienced HCWs were 2.1[1.3-3.5] times and 4.9[2.6-9.2] times more likely to exhibit negative perceptions of the two outcomes (adj. P < 0.001 each).

CONCLUSIONS

A negative perception of the effectiveness of MERS-CoV knowledge transfer was associated with poorer knowledge and was more prevalent among male HCWs, physicians/pharmacists and less experienced HCWs. Hospitals should always refer to efficient knowledge sharing and educational strategies that render beneficial outcomes to patients, HCWs, and the public community.

Awareness of primary health care physicians about human papilloma virus infection and its vaccination: a cross-sectional survey from multiple clinics in Saudi Arabia

Background

The incidence of human papilloma virus (HPV) infections in conservative populations is increasing, yet vaccination is not routinely recommended by primary health care (PHC) physicians. The aim of this study is to evaluate PHC physicians’ awareness of HPV infections and vaccination in Saudi Arabia.

Materials and methods

A self-administered survey was conducted in 2017 at eleven PHC clinics in Saudi Arabia. Their knowledge on HPV infections (six statements) and HPV vaccines (ten statements), their perceived importance of HPV vaccine, and if they recommended this vaccine to their patients was evaluated. Knowledge scores were summated and commuted into percentage mean scores (PMS). Analyses were conducted to identify factors associated with these outcomes.

Results

Almost 80% of physicians perceived HPV vaccine as necessary and important, while 33 (16.5%) actually recommend HPV vaccine to their patients. Overall PMS± standard deviation of knowledge on HPV infections and vaccine was 61.8±10.4 and 91.3±11.4, respectively. Female physicians had a better perception of the importance of the vaccine (94; 84.7%), compared to male physicians (65; 73.0%), P=0.043. Younger physicians (<38 years) had better perception of the importance of HPV vaccine (75; 88.2%), compared to older physicians (≥38 years) (84; 73%), P=0.009. Family medicine physicians were more knowledgeable about both HPV infections (62.1±9.7) and HPV vaccine (91.2±12.0), compared to physicians of other specialties (56.3±13.7 and 85.8±10.2), P=0.03 and P=0.007, respectively. PHC physicians who routinely recommended HPV vaccine were also more knowledgeable (96.7±5.4), P=0.005. Compared to males, females were 3.1 times more likely to recommend HPV vaccines, adjusted P=0.015. Physicians who had better perception of the importance of vaccine were 4.8 times more likely to recommend vaccination, adjusted P=0.042.

Conclusion

Enhancing PHC physicians’ knowledge about HPV infections and the efficiency of its vaccine boosts the physicians’ confidence to recommend HPV vaccination. Special consideration should be paid to male PHC physicians and older physicians, who had poorer perception of the importance of HPV vaccines in comparison to their counter groups.