Good practice regarding smoking cessation management in Spain: Challenges and opportunities for primary care physicians and nurses

Carlos Martin-Cantera, Jose M Iglesias Sanmartín, Ana Furió Martínez, Cesar Minué Lorenzo, Vidal Barchilón Cohen, Maria L Clemente Jiménez, Sara Cascón Pérez-Teijón, Joan A Ribera I Osca, Rodrigo Córdoba García, Joan Lozano Fernández, Miguel A Gallardo Domenech, Maria A Mendiguren Navascues, Emilio Salguero Chaves, María L Rodríguez Ibañez, Victoria Gueto Rubio, Susana Morena Rayo, Bruno Marioni Otero, Lucia Gorreto Lopez, Francisco Camarelles Guillem, Fernando Martín Fuente, Diego Beni Ruiz, Alicia I Hernández Rodríguez, Juan De Dios González Caballero, Cruz Bartolomé Moreno, Mercé Pau Pubil, Merce Lopez Grau, Carlos Martin-Cantera, Jose M Iglesias Sanmartín, Ana Furió Martínez, Cesar Minué Lorenzo, Vidal Barchilón Cohen, Maria L Clemente Jiménez, Sara Cascón Pérez-Teijón, Joan A Ribera I Osca, Rodrigo Córdoba García, Joan Lozano Fernández, Miguel A Gallardo Domenech, Maria A Mendiguren Navascues, Emilio Salguero Chaves, María L Rodríguez Ibañez, Victoria Gueto Rubio, Susana Morena Rayo, Bruno Marioni Otero, Lucia Gorreto Lopez, Francisco Camarelles Guillem, Fernando Martín Fuente, Diego Beni Ruiz, Alicia I Hernández Rodríguez, Juan De Dios González Caballero, Cruz Bartolomé Moreno, Mercé Pau Pubil, Merce Lopez Grau

Abstract

Introduction: We analyze the activities carried out by primary care (PC) physicians and nurses with respect to smoking cessation and evaluate their self-reported training, knowledge, and behavior.

Methods: A cross-sectional study was conducted including 1514 PC physicians and nurses from June 2016 to March 2017, in Spain. The main variable was Good Practice (GP) in attention to smokers. To identify associated factors, a multilevel logistic regression model was used adjusted for sex, age, type of center, contract, years of employment, tobacco consumption, and self-reported training/knowledge.

Results: Of the 792 physicians and 722 nurses, 48.6% referred to GP in smoking cessation management. The finding related to: being a non-smoker (OR=1.8; 95% CI: 1.2-2.5) or ex-smoker (OR=1.4; 95% CI: 1.02-2.1), having a good level of knowledge (OR=1.8; 95% CI: 1.3-2.4) and training (OR=2.4; 95% CI: 1.8-3.2), and, to a lesser extent, being female (OR=1.3; 95% CI: 1.03-1.7), and work experience >10 years (OR=1.4; 95% CI: 1.03-1.9). The main GP barriers were: lack of time (45.5%), organizational problems (48.4%), and 35.4% lack of training.

Conclusions: The GP of PC physicians and nurses regarding smoking cessation management is related to being non-smokers or ex-smokers, and having sufficient training and knowledge. Lack of time and organizational problems were considered to be the main barriers. The promotion of training activities in the Spanish National Health Service with the support of scientific societies is required.

Keywords: Public Health Practice; attitudes; clinical competence; primary healthcare; smoking cessation; surveys and questionnaires.

Conflict of interest statement

The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work.

© 2020 Martin-Cantera C. et al.

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