Abstract
ObjectivesThis 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.MethodsThis 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.ResultsA 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.ConclusionOverall, 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.
Highlights
Tobacco use is a major modifiable risk factor for non-communicable diseases and is responsible for six million deaths annually.[1]
Establishing cessation services as part of the package of care in primary health centres could address the time constraints barriers identified by the primary care physicians (PCPs)
Al Hosani et al reported that a similar proportion (72.1%) of personnel working in primary care centres in the United Arab Emirates (UAE) had not received specific training on smoking cessation.[23]
Summary
Tobacco use is a major modifiable risk factor for non-communicable diseases and is responsible for six million deaths annually.[1]. A meta-analysis found that tobacco dependence treatment (TDT) interventions significantly reduced tobacco use in the short term while maintaining cessation efforts over time.[6]. The World Health Organization (WHO) Framework Convention on Tobacco Control stipulates that nations should address tobacco dependence by promoting cessation services.[7,8] Common interventions include counselling through regular health services, telephone quit lines and access to pharmacological therapy. Specialised TDT clinics should be established and staffed by trained physicians in order to provide appropriate motivational counselling and prescriptions for nicotine replacement therapy (NRT), most forms of which are usually available over the counter.[7,8] In June 2019, the price of tobacco products doubled due to the addition of tax; this change is expected to increase demand for tobacco cessation services, in low- and middle-income countries.[3,9]
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