Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia

Narine K Movsisyan, Petrosyan Varduhi, Harutyunyan Arusyak, Petrosyan Diana, Muradyan Armen, Stillman A Frances, Narine K Movsisyan, Petrosyan Varduhi, Harutyunyan Arusyak, Petrosyan Diana, Muradyan Armen, Stillman A Frances

Abstract

Background: Smoking cessation counseling by health professionals has been effective in increasing cessation rates. However, little is known about smoking cessation training and practices in transition countries with high smoking prevalence such as Armenia. This study identified smoking-related attitudes and behavior of physicians and nurses in a 500-bed hospital in Yerevan, Armenia, the largest cancer hospital in the country, and explored barriers to their effective participation in smoking cessation interventions.

Methods: This study used mixed quantitative and qualitative methods. Trained interviewers conducted a survey with physicians and nurses using a 42-item self-administered questionnaire that assessed their smoking-related attitudes and behavior and smoking cessation counseling training. Four focus group discussions with hospital physicians and nurses explored barriers to effective smoking cessation interventions. The focus group sessions were audio-taped, transcribed, and analyzed.

Results: The survey response rate was 58.5% (93/159) for physicians and 72.2% (122/169) for nurses. Smoking prevalence was almost five times higher in physicians compared to nurses (31.2% vs. 6.6%, p < 0.001). Non-smokers and ex-smokers had more positive attitudes toward the hospital's smoke-free policy compared to smokers (90.1% and 88.2% vs. 73.0%). About 42.6% of nurses and 26.9% of physicians reported having had formal training on smoking cessation methods. While both groups showed high support for routinely assisting patients to quit smoking, nurses more often than physicians considered health professionals as role models for patients.

Conclusions: This study was the first to explore differences in smoking-related attitudes and behavior among hospital physicians and nurses in Yerevan, Armenia. The study found substantial behavioral and attitudinal differences in these two groups. The study revealed a critical need for integrating cessation counseling training into Armenia's medical education. As nurses had more positive attitudes toward cessation counseling compared to physicians, and more often reported having cessation training, they are an untapped resource that could be more actively engaged in smoking cessation interventions in healthcare settings.

References

    1. WHO. WHO report on the global tobacco epidemic, 2008: the MPOWER package. Geneva: World Health Organization; 2008.
    1. WHO. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011.
    1. Giovino GA. et al.Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet. 2012;380(9842):668–679. doi: 10.1016/S0140-6736(12)61085-X.
    1. Cohen DR, Fowler GH. Economic implications of smoking cessation therapies: a review of economic appraisals. Pharmaco Economics. 1993;4(5):331–344. doi: 10.2165/00019053-199304050-00004.
    1. Fiore MC. Treating tobacco use and dependence: an introduction to the US Public Health Service Clinical Practice Guideline. Respir Care. 2000;45(10):1196–1199.
    1. WHO. Policy recommendations for smoking cessation and treatment of tobacco dependence: tools for public health. Geneva: World Health Organization; 2004.
    1. Rigotti NA, Munafo MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev. 2007;3:CD001837.
    1. Fowler G. Educating doctors in smoking cessation. Tob Control. 1993;2:5–6. doi: 10.1136/tc.2.1.5.
    1. Nett LM. The physician's role in smoking cessation. A present and future agenda. Chest. 1990;97(2 Suppl):28S–32S.
    1. Smith DR. The historical decline of tobacco smoking among United Statesphysicians: 1949–1984. BMC Tobacco Induced Diseases. 2008;4(9)
    1. Smith DR, Leggat PA. An international review of tobacco smoking in the medical profession: 1974–2004. BMC Publ Health. 2007;7:115. doi: 10.1186/1471-2458-7-115.
    1. Warren CW. et al.Tobacco use and cessation counselling: cross-country. Data from the Global Health Professions Student Survey (GHPSS), 2005–7. Tob Control. 2008;17(4):238–247. doi: 10.1136/tc.2007.023895.
    1. Gyurjyan G, Bazarchyan A. Report on the results of the national survey on the drug, alcohol and smoking prevalence among the general population of Armenia 2005. 2005. .
    1. Movsisyan NK, Petrosyan V. Analytical Review of the Tobacco Control Policy in Armenia 2005–2007. Yerevan, Armenia: American University of Armenia; 2008.
    1. Movsisyan NK, Thomspon ME, Petrosyan V. Attitudes, practices and beliefs towards worksite smoking among administrators of private and public enterprises in Armenia. Tob Control. 2010;19(4):274–278. doi: 10.1136/tc.2009.031658.
    1. Perrin PC. Patterns of smoking behavior among physicians in Yerevan, Armenia. BMC Publ Health. 2006;6(139)
    1. Stillman FA, Hantula DA, Swank R. Creating a smoke-free hospital: attitudes and smoking behaviors of nurses and physicians. Am J Health Promot. 1994;9(2):108–114. doi: 10.4278/0890-1171-9.2.108.
    1. Carr A. The easy way to stop smoking. 3rd edition. London: Penguins Book; 1999.
    1. Abdullah AS, A review of tobacco smoking and smoking cessation practices among physicians in China: 1987–2010. Tob Control. 2011. [pii] 10.1136/tobaccocontrol-2011-050135. tobaccocontrol-2011-050135.
    1. Hodgetts G, Broers T, Godwin M. Smoking behaviour, knowledge and attitudes among family medicine physicians and nurses in Bosnia and Herzegovina. BMC Fam Pract. 2004;5(12)
    1. Parna K, Rahu K, Rahu M. Smoking habits and attitudes towards smoking among Estonian physicians. Public Health. 2005;119(5):390–399. doi: 10.1016/j.puhe.2004.07.005.
    1. Ravara SB, Calheiros JM, Aguiar P, Barata LT. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban. BMC Publ Health. 2011;11(720)
    1. Kelly NR, Cohen FL. Smoking policies in U.S. hospitals: Current status. Prev Med. 1979;8(5):557–561. doi: 10.1016/0091-7435(79)90331-1.
    1. Longo DR, Brownson RC, Kruse RL. Smoking bans in US hospitals. Results of a national survey. JAMA. 1995;274(6):488–491. doi: 10.1001/jama.1995.03530060062035.
    1. Nagle AL, Schofield MJ, Redman S. Smoking on hospital grounds and the impact of outdoor smoke-free zones. Tob Control. 1996;5(3):199–204. doi: 10.1136/tc.5.3.199.
    1. Fitzpatrick P. et al.Implementation of a campus-wide Irish hospital smoking ban in 2009: prevalence and attitudinal trends among staff and patients in lead up. Health Promot Int. 2009;24(3):211–222. doi: 10.1093/heapro/dap020.
    1. Williams SC. et al.The adoption of smoke-free hospital campuses in the United States. Tob Control. 2009;18(6):451–458. doi: 10.1136/tc.2009.030494.
    1. Nersesyan AK. Efficacy of cancer treatment in Armenia: where is it going. Cancer Therapy. 2008;6:683–686.
    1. Garfinkel L, Stellman SD. Cigarette-Smoking among Physicians, Dentists, and Nurses. CA Cancer J Clin. 1986;36(1):2–7. doi: 10.3322/canjclin.36.1.2.
    1. Warren CW. et al.Tobacco use, exposure to secondhand smoke, and training on cessation counseling among nursing students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005–2009. Int J Environ Res Public Health. 2009;6(10):2534–2549. doi: 10.3390/ijerph6102534.

Source: PubMed

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