Abstract
Background
Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians’ attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia.
Methods
A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values <0.05 were considered to be significant.
Results
Response rate was 73/150 (48.6%), of which equal sex distribution (52%:48%) was observed, with a mean age of 35.3±9.6 years. General practitioners constituted 71.4%, followed by consultants (17.9%) and specialists (10.7%). Those with a postgraduate education formed 49.3%, while experience averaged 9.5±9.2 years. Approximately 56% had not attended a smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3–242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6–54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6–23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008).
Conclusion
Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper delivery of smoking cessation advice may increase physicians’ confidence; improve their attitude, and subsequently, their practice.
Acknowledgments
This study was initiated and funded by King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. The authors would like to thank the research office and the institutional review board for their support. The efforts of the department of family medicine are appreciated. Special thanks to Ms AlAnoud Hasher, the promotional coordinator from the strategy and business development section, who coordinated the language and scientific editing between the authors and the Macmillan Science Communication.
Author contributions
MA, AMA, and MK conceptualized and designed the study. AMA and MK obtained data and supervised the conduct of the study. MS was responsible for the quality control, and provided statistical advice on study design, analyzed the data and drafted the manuscript. All authors contributed substantially to its revision as submitted, gave final approval and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.