Irish Healthcare staff- Smoking, training and activity in treatment of tobacco dependence -an online survey (original) (raw)
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Tobacco Prevention & Cessation, 2020
INTRODUCTION Although brief smoking cessation interventions that follow the 5As algorithm (Ask, Advise, Assess, Assist, Arrange) can trigger smokers to quit, routine delivery remains low in Europe. This study aimed to identify the extent of smoking cessation practices of healthcare professionals interested in tobacco cessation, and their opinions and attitudes. METHODS A quantitative, cross-sectional survey design was adopted. Healthcare professionals (n=133) who attended one of ten training sessions on brief interventions for smoking cessation, held every month between September 2018 and June 2019 in Malta, were recruited. Univariate logistic regression and non-parametric tests were carried out to identify associations by participants' characteristics. Potential confounders were ruled out following multivariate analyses. RESULTS Most participants were female nurses who had never smoked. While most professionals reportedly asked (76.3%), advised (83.5%) and assessed (70.5%) patients for cessation, fewer provided assistance (40.9%) and arranged followup (24.2%). Compared to other participants, doctors were more likely to have counselled patients over the previous week. Most professionals were favourably disposed towards counselling patients to quit, however, they claimed they had insufficient time to do so. Although most found it difficult to get clients to quit, former smokers were more likely to disagree when compared to those who never smoked (OR=6.86; 95% CI: 2.17-21.71; p=0.001). CONCLUSIONS While more initiatives to train healthcare professionals in providing smoking cessation interventions are recommended, lack of sufficient time, being an organisational barrier, requires healthcare management exploration and action. Given that former smokers were more confident in helping patients quit, engaging them in training activities would be of added value.
Irish journal of medical science, 2012
BACKGROUND: The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit. AIMS: To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital. METHODS: Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital. RESULTS: Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe. CONCLUSIONS: Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.
Imperative training need of health professionals for improved smoking cessation services
2013
This is a national cross-sectional survey of Mauritian health professionals working in the public service. The study population consists of health professionals in the fields of medicine, nursing/midwifery and dentistry, working in the public sector of Mauritius. Stratified random sampling was used; the strata consisted of various categories of health professionals, namely Medical Officers (doctors), Specialist Doctors, Dental Officers (dentists) and Qualified Nurses/Midwives. Considering a margin of error of 5%, at a confidence level of 95%, a minimum sample size of 370 was targeted. In case of refusal to participate in the survey, non-respondents were Abstract: Mauritius is one of the twelve sub-Saharan countries which participated in the African Tobacco Situation Analysis initiative, whereby the need to survey health professionals on their knowledge, attitudes, beliefs and practices with respect to tobacco use and smoking cessation was identified. A national cross- sectional surv...
Cyprus Journal of Medical Sciences, 2022
BACKGROUND/AIMS: Smoking is common affecting millions of subjects worldwide and is linked to numerous medical disorders. We aimed to determine and to evaluate the appropriateness of smoking cessation counseling to adult active smokers. MATERIALS AND METHODS: This cross-sectional study conducted between October 2014-May 2015 and statistical analysis of the data was performed in June 2015 in a university hospital. Adult patients under 65 years of age seen at the general internal medicine clinics were asked to fill in a questionnaire about smoking habits, doctors' questioning about smoking status, and advice received about smoking cessation. RESULTS: A total of 512 patients (64.6% females) with a mean age of 39±14 years completed the questionnaire. Of them, 142 (27.7%) were active smokers. The mean age of the current smokers was 39±12 years and 52.1% were females. Fagerström test revealed that 33.8% of them were high-dependent smokers. Among the smokers, 135 (95.1%) reported having been asked about their smoking status and 72.5% had been advised to quit smoking. Any method to quit smoking was discussed with only 41 (28.9%) of smokers. The most common advice was to visit the smoking cessation clinic of the same hospital. The advice rate for smoking cessation did not change with regard to the dependence score. CONCLUSION: Although asking about smoking was a common practice in internal medicine clinics, advising about cessation and discussing methods for cessation in particular, were not parts of the doctor visit in many of the patient-doctor encounters. Smoking cessation counseling should be an indispensable part of the patient examination.
Exploring the views of healthcare professionals on increasing smoking cessation advice for patients
Background: Smoking cessation advice provided by healthcare professionals can be effective in increasing smoking cessation among patients. Any successful intervention will require staff knowledge of local barriers to implementation. However, the views of Irish healthcare professionals on increasing the provision of smoking cessation advice and the associated barriers remain unexplored. Aims: To explore the views of Irish healthcare professionals on barriers to increasing smoking cessation advice for patients in a large Irish university teaching hospital. Method: Semi-structured interviews were conducted separately with 16 healthcare professionals in a large Irish university teaching hospital. Results: The main barriers identified were patient and staff attitudes, time and service constraints, information not readily available, and issues and opinions on a smoke-free campus policy in a hospital setting. Conclusion: Our results revealed several barriers, expressed by Irish healthcare professionals, to providing smoking cessation advice to patients. This supports the need to implement a multi-component intervention in a hospital setting to improve the rate of provision of smoking cessation advice in patients by healthcare professionals.
Brief cessation advice from health-care professionals in the hospital setting significantly increases the likelihood of patients quitting smoking, yet patients are not routinely provided with this advice. Smoke-free hospital policies aim to protect individuals from the adverse effects of smoking; however, it is unclear if such policies encourage systematic delivery of cessation advice by health-care professionals. The study's aim was to determine the prevalence of smoking and cessation advice received by in-patients in two teaching hospitals in Ireland which have implemented smoke-free hospital policies, and to examine patient attitudes towards smoking cessation. Change in smoking prevalence and delivery of smoking cessation advice prior to and post-policy implementation was also examined in one hospital. This study surveyed 466 in-patients across 2 hospital sites, over a 3-week and 5-week period, respectively. Data were also compared to a survey completed prior to the implementation of the smoke-free policy in one of the hospital sites. Smoking prevalence was 17% in Beaumont Hospital and 28% in Connolly Hospital. Overall, nicotine dependence was low (Mean Fagerström Test for Nicotine Dependence = 4.21, ±2.9). Overall, 62% of smokers did not receive smoking cessation advice from a health professional, although 55% indicated a willingness to engage with this type of service. The before-and-after analysis of Beaumont Hospital showed a reduction in smoking prevalence (17% vs 21%) amongst hospital in-patients, and a 6% increase in reported cessation advice provided following the introduction of the hospital smoke-free policy. Smoke-free hospital policies play a role in decreasing the prevalence of in-patient smokers, but further intervention is needed to increase rates of cessation advice provided. Positive attitudes to smoking cessation, coupled with low average nicotine dependence, suggest that low-intensity interventions would be beneficial for most smokers. A systematic focus on provision of brief smoking cessation advice is needed in hospitals.
Smoking cessation assisted by primary healthcare professionals
Journal of Nursing Education and Practice
Background: The effectiveness of smoking cessation treatments has been well studied, but most smokers quit without assistance from a health professional. To further improve our understanding of how primary healthcare efforts can benefit patients who attempt to quit, we need a deeper understanding of how the process unfolds when assisted by a primary healthcare professional and how this is experienced by the smoker. Objective: To construct an emergent model of the smoking cessation process assisted by a primary healthcare professional. Methods: Data were collected from video recordings of primary healthcare professionals in office sessions to promote smoke cessation in Barcelona Province (Catalonia, Spain). Thirteen smokers and their primary healthcare professionals engaged in 24 preparatory sessions and 23 follow-up sessions. Data were analysed according to Constant Comparative Analysis Method along with conceptual and theoretical frameworks. Results: Smoking cessation is a social process that is shaped by interactions and relationships with primary healthcare professionals. Four categories explain the process: 1) Feeling addicted and wanting help to quit smoking; 2) Preparing to quit smoking: anticipating abstinence; 3) Managing smoking abstinence: a positive or transitional process; and 4) Controlling the urge to smoke: a central process in smoking cessation. Conclusions: Primary healthcare professionals treat smoking behaviours as a health problem and supervise the process of enabling the smoker to learn how to control the urge to smoke. Learning to control smoking abstinence is not always enough to enable the individual to reorganize and restructure daily life without cigarettes. Primary healthcare professionals should be encouraged to incorporate not only logic and scientific evidence but also the subjectivity of the patient's attitude into efforts to better respond to the changing, complex nature of the smoking cessation process.
Nicotine & Tobacco Research, 2013
introduction: This study examined the effectiveness of low-intensity, practice-tailored training for general practitioners (GPs) aimed at personal and organizational barriers that arise when routinely asking patients' smoking status, advising to quit, and arranging follow-up. Methods: A cluster-randomized controlled trial with 49 GPs and 3,401 patients (677 smokers). Two patient groups participated: 2,068 patients (433 smokers) at baseline and 1,333 patients (244 smokers) postintervention. At follow-up, 225 smokers of both groups participated. The primary outcome was GP smoking cessation counseling (asking about smoking status, advising to quit, prescribing pharmacotherapy, and referring for behavioral support). Secondary outcomes were GPs' attitudes toward smoking cessation care, patients' intention to quit, and long-term quit rates. Outcomes were measured with GP self-report and patient report. results: Patients of trained GPs reported more often being asked about smoking behavior compared with patients of untrained GPs (OR = 1.94, 95% CI = 1.45-2.60). According to GP self-report, the training increased the provision of quit-smoking advices (difference 0.56 advice per day; 95% CI = 0.13-0.98) and the ability and intention of providing smoking cessation care. We found no effect on GPs' arrangement of follow-up, smokers' intention to quit, and long-term quit rates. Conclusions: After 1 hour of training, we found significant differences between trained and untrained GPs on the frequency in which they asked about smoking (patient reported) and advised smokers to quit (GP self-reported). The training did not increase prescriptions of pharmacotherapy, referrals to behavioral support, or quit rates. Future training methods should focus on the GPs' ability, tools, and skills to arrange follow-up to ensure intensive smoking cessation support. intrOduCtiOn General practitioners (GPs) play a key role in the delivery of smoking cessation interventions to their patients. Even a GPs' minimal intervention of advising smokers to quit has the potential to significantly benefit smokers' motivation to quit and smoking abstinence (Pieterse, Seydel, de Vries, Mudde, & Kok, 2001; Stead, Bergson, & Lancaster, 2008). Guidelines recommend that GPs put into practice a systematic approach of asking every patient about tobacco use, advising all smokers to quit, assessing smokers' willingness to make a quit attempt, assisting smokers with treatment and referrals, and arranging follow-up contacts (5-A model;
Abstract Hospitalisation is an ideal time to implement smoking cessation interventions, and brief cessation advice from healthcare practitioners increase quit rates among hospitalised smokers. However, little is known about the extent inpatients receive such advice, or the impact it has on motivation to quit and quitting behaviours post-hospitalisation. This study aimed to determine the prevalence of smoking and cessation advice received by in-patients in two teaching hospitals in Ireland, and the impact of same 3-months post-discharge. Methods We surveyed 1001 in-patients across two hospital sites, over a six month period. Demographic details, clinical history, smoking history, motivation to quit, cigarette dependence and recent quitting history were assessed. Telephone follow-up at 3-months post-hospitalisation was used to establish post-discharge motivation to quit and establish smoking behaviours and quit attempts. A sample of self-reported quitters were asked to provide a breath sample using a carbon monoxide monitor (CO) to objectively assess smoking status at 3-months. Results Prevalence of smoking within the sample was 23.4% (235/1001). Only 32% (75/235) of smokers reported that smoking cessation was discussed during admission. Patient smoking status was documented in the records of 57% (132/235) of smokers. Smokers’ mean Fagerstrom nicotine dependence score was 3.7 (SD=2.7), indicating low dependence levels. At 3 months, 17% (25/146) of smokers reported smoking cessation, with 68% confirmed on CO test (17/25). Provision of smoking cessation advice during hospitalisation was associated with higher motivation to quit (OR=2.79, 95% CI 2.12-3.68), and successful quit behaviour (OR=2.02, 95% CI 1.34-3.06). Conclusions The current study finds that provision of brief cessation advice and smoking status documentation is suboptimal in two hospitals in Ireland. Where advice was given, it was associated with enhanced motivation to quit and increased quit rates. These findings, along with low average nicotine dependence scores in smokers, suggest that systematic provision of low-intensity cessation interventions could significantly enhance quit rates in hospitalised smokers.