Smoking cessation counseling: Attitude in the background of poor practice compliance among Palestinian primary health care physicians: a cross-sectional study

Abstract

Objectives: Healthcare systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that smoking cessation advice to patients in primary health care is suboptimal. This study aimed at assessing Palestinian PHC physicians’ compliance and attitude towards smoking cessation counseling and their determinants.

Methods: The study utilized a cross-sectional study design using a self-reported questionnaire targeted general practitioners, family medicine doctors, obstetrics & gynecologists, and dentists working at PHC Centers in Palestine from April to September 2019. A proportional stratified random sampling method was used. Socio-demographic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence, and attitude, were assessed.

Results: Two-hundred ninety-four PHC physicians participated in the study with a high response rate. More than half (53%) were between 31-45 years of age. Most of them (76.5%) were general practitioners seeing more than 30 patients per day (66%), and only 15% (n = 40) get training about smoking cessation counseling. Practice compliance was low; only 39 (13.3%) reported adherence to smoking cessation practice. The participant physicians’ attitude level was good as the overall attitude score mean 75.1 ± 9.6. A positive attitude, assigned as any score ≥ 65, was observed in 87.7% (n = 258) of physicians. Job title, experience, and knowledge are predictors of a positive attitude towards smoking cessation counseling.

Conclusions: Building a supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their confidence level and enhance their practice in smoking cessation counseling.