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

Prevalence of Lifestyle Factors Among Primary Care Physicians: A Cross-Sectional Study in Al-Ahsa, Saudi Arabia

Introduction The importance of a healthy lifestyle has grown in significance on a global scale, as it offers a vital means of preventing and managing a range of related illnesses. Consequently, maintaining a healthy lifestyle is of paramount importance for the prevention and management of non-communicable diseases. The lifestyle behaviors of healthcare workers exert a significant influence on their attitudes and counseling methods, as they play a pivotal role in the promotion of health and the dissemination of lifestyle education to patients and the general population. Objective The objective of this study was to examine the prevalence of lifestyle factors among primary care physicians in Al-Ahsa Governorate, including smoking, body mass index, nutrition, physical activity, and caffeine consumption. Methods The study was conducted between December 2023 and February 2024. A total of 233 primary care physicians in Al-Ahsa were selected through a probability multistage clustering sampling method. Data were collected via the distribution of a self-administered questionnaire to the primary care physicians and were analyzed using the chi-square test. Results A greater proportion of primary care physicians exhibited multiple unhealthy lifestyle factors (166/233, 71.2%). The most prevalent lifestyle factor was low physical activity (169/233, 73%), followed by poor nutrition (121/233, 52%), obesity (120/233, 51.51%), smoking (37/233, 15.88%), and caffeine consumption (22/233, 9%). The majority of primary care physicians with optimal health status are employed in primary healthcare (PHC) facilities situated in the eastern region followed by the southern region in Al-Ahsa Governorate. Conclusion The study findings revealed a prevalence of unhealthy lifestyle factors among the majority of primary care physicians in the Al-Ahsa Governorate. The most prevalent unhealthy lifestyle factor among the participants was low physical activity.

Intensive Intervention on Smoking Cessation in Patients Undergoing Elective Surgery: The Role of Family Physicians

Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians' clinics in which smokers of both sexes, aged 21-65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32-23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term.

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.

Comprehensive Training of Community Diagnosis and the Community-Oriented Primary Health Care Model in Nursing Education: An Evidence-Based Project

BACKGROUND

Community-oriented primary health care is a health promotion model that includes community diagnosis of a targeted community.

PURPOSE

This educational project aimed to develop and implement an innovative approach of applying the principles of evidence-based practice in the teaching of community diagnosis, where the class of nursing students serves as an example of community.

METHODS

The method consisted of a lecture and an evidence-based simulation of community diagnosis based on data collection regarding the lifestyle and health behaviors of third-year nursing students from a 4-year academic nursing program (200 students; 90% response rate).

RESULTS

The data analysis revealed insufficient consumption of fruits, vegetables, and unsweetened fluids; excessive consumption of red and processed meat; insufficient engagement in physical activity; high anxiety level; and sleep deprivation.

CONCLUSIONS

This educational approach allowed an interactive presentation of community health diagnostic methodology as well as community health problem prioritization applying the principles of an evidence-based approach. The method also improves students' awareness of their health and makes them better ambassadors of promoting a healthy lifestyle.

De-normalizing smoking in urban areas: Public smoking bans and smoking prevalence

The effectiveness of command-and-control policies related to tobacco use has been studied in high-income countries. Still, there is limited evidence of their effects in low and middle-income countries. We explore the case of Colombia, a country that introduced a business-supported smoking ban in bars and restaurants and all public indoor spaces in 2010. This paper investigates the effect of smoking bans in bars and restaurants on smoking prevalence in Bogotá, Colombia. In this paper, we use the matching with triple-differences technique in analyzing household consumption data from the 2007 and 2011 quality of life surveys. This is done by exploiting their geographical proximity and variation in the density of commercial areas. We found that after the smoking ban implementation, smoking prevalence reduced in households near high-density commercial blocks compared to households near low-density commercial blocks (-10.8 pp.). The impact is larger for households with children and older household heads. Since households near high-density commercial blocks are more frequently exposed to smoking than households near low-density commercial blocks, the former would be more willing to internalize the smoking de-normalization process.

Cross-sectional online survey to determine the prevalence, knowledge, attitude and practice of tobacco cessation among governmental healthcare workers in Qatar

OBJECTIVES

One effective approach of tobacco control is to encourage the role and the participation of healthcare workers in the prevention efforts against tobacco use. This study aimed to determine the prevalence of tobacco use among governmental healthcare workers in Qatar, to assess healthcare workers' knowledge, attitude and practice of tobacco cessation and to predict factors associated with above average tobacco cessation practice scores.

DESIGN

A cross-sectional survey study was conducted among healthcare workers working in Hamad Medical Corporation and Primary Healthcare Centres in Qatar using a self-administered online questionnaire in 2019.

SETTING

Hamad Medical Corporation and Primary Healthcare Centres in Qatar.

PARTICIPANTS

Governmental healthcare workers aged 18 years and above (n=7214).

RESULTS

The response rate of our online survey was 20.6% (7214/35 000). Of the 7214 healthcare workers, 16.3% (n=1178) were current tobacco users. In particular, the prevalence of tobacco use among physicians was 11.0%. Fifty-two per cent of healthcare workers (n=2338) attained an average knowledge score (12-17), 71.8% (n=3094) attained positive attitude scores (8-12) and 57.1% (n=3052) attained above average practice scores (12-26). Among the different professions, physicians were having the highest mean knowledge (15.3±4.7), attitude (9.4±1.9) and practice (13.7±6.1) scores. Multivariate analysis showed that having good knowledge (adjusted OR (AOR)=2.8; p<0.0001) and training (AOR=2.4; p<0.0001) were the strongest factors associated positively with above average tobacco cessation practice scores.

CONCLUSIONS

Healthcare workers in Qatar have a relatively similar prevalence of tobacco use than earlier studies with no significant increase. Investing more in training programmes for healthcare workers are needed to root out this negative behaviour and to increase their skills to assist users to quit.