Health care providers knowledge, attitude and practice of smoking cessation interventions in public health facilities in Kiambu county, Kenya

Abstract

Healthcare providers can play a major role in promoting smoking cessation by providing either behavioral and/or pharmacological smoking cessation interventions to their patients. Such smoking cessation interventions have been shown to be effective in increasing the quit rate in patients who smoke. The knowledge and attitudes of healthcare providers towards provision of smoking cessation interventions can however determine if smoking patients receive these interventions. Objective The aim of this study was to determine healthcare providers’ level of knowledge, attitude and practice of smoking cessation interventions. Methodology This was a cross- sectional study carried out among healthcare providers working in public health facilities in Kiambu County. Four hundred participants were selected to participate in the study from five health professional groups: nurses, medical officers, dentists, clinical officers and community oral health officers. A two-stage stratified sampling technique was employed to select participants. Selection of health facilities formed the first stage while selection of health care providers formed the second stage. Self administered questionnaires were then distributed to the selected participants. Descriptive statistics was used to report frequency distribution of study variables. Chi-square tests and odds ratio were used to assess socio-demographic differences in the knowledge, attitude and practice of health care providers. Results A total of 338 participants completed the questionnaire. Half of the participants attained an average knowledge score, 41% of the participants attained poor knowledge scores, while 8% attained good knowledge scores. Most of the respondents (89%) had not received formal training on smoking cessation interventions. Majority of the participants (85%) had a positive attitude towards provision of smoking cessation interventions however, non-smokers had significantly more positive attitudes towards provision of smoking cessation interventions than current smokers. Overall, less than half of the health care providers reported that they always provided smoking cessation interventions to their patients. More health care providers reported that they always asked (35%) and advised (44%) smokers to quit as compared to those that always assessed willingness to quit (16%), assisted patients set a quit date (10%) or arranged follow up of patients after quitting (12%). Insufficient training, lack of smoking cessation treatment guidelines and insufficient knowledge were rated by most health care providers as important barriers to the provision of smoking cessation interventions. Conclusion Health care providers have inadequate knowledge on smoking cessation interventions. Most health care providers surveyed had a positive attitude towards provision of smoking cessation interventions. There was sub-optimal self reported practice of smoking cessation interventions by the health care providers surveyed. Recommendation There is need to improve health care providers’ knowledge, confidence and practice levels on smoking cessation interventions through development and implementation of a pre-service and in-service standard curriculum for training healthcare providers on smoking cessation interventions. National guidelines for screening, documentation and treatment of tobacco dependence also need to be developed and implemented.