Assessing smoking cessation services and pharmacotherapy in Namibia: findings and implications for future policy initiatives

ABSTRACT

Background

Tobacco smoking is a considerable barrier to reducing morbidity and mortality associated with non-communicable diseases (NCDs). However, few studies in sub-Saharan Africa have explored access to smoking cessation programs including smoking cessation pharmacotherapy (SCP). This needs to be addressed given the growing burden of NCDs across sub-Saharan Africa including Namibia.

Methods

Multi-facility cross-sectional survey among physicians in both public and private sectors in Namibia.

Results

Of the 106 physicians recruited, 69% practiced in public health facilities and 92% were nonsmokers. Sixty-seven percent offer smoking cessation services, with 64% of these offering SCP. This was mainly nicotine replacement therapy (53%) and bupropion SR (41%). Overall, all physicians had a low knowledge score of SCP (<50%). The mean knowledge score though was 77% lower among physicians in public versus private sectors (OR = 0.23, 95%CI: 0.14–0.35, p < 0.001). Principal barriers to prescribing SCP were inadequate knowledge and/or lack of smoking cessation guidelines. This is not surprising with SCP medicines not currently listed within the public medicine list in Namibia.

Conclusion

Despite good attitudes toward SCP, there are concerns with physicians’ knowledge and practices especially in the public sector. There is an urgent need to address this and integrate services to reduce NCDs in Namibia.

KEYWORDS:

• Smoking cessation
• pharmacotherapy
• physicians
• Namibia
• guidelines

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

E Hango, D Kibuule, and F Kalemeera developed the concept for the paper and the methodology including the questionnaire; E Hango, K Amakali, A Shilunga, and F Kalemeera were involved with data collection and analysis; E Hango and B Godman undertook the literature review; E Hango, D Kibuule, B Godman, and F Kalemeera undertook the analysis and all authors were involved with writing the initial paper with E Hango, B Godman, and F Kalemeera involved in updating the paper following reviewer and editorcomments. All authors agree for the final version to be published and to be accountable for all aspects of the work.

Additional information

Funding

The authors received no financial support from any organization for conducting the research.