Research paper
 
CC-BY-NC 4.0
 
 

Pharmacist-led smoking cessation: The attitudes and practices of community pharmacists in Lagos state, Nigeria. A mixed methods survey

Bolajoko Aina 2,  
Chioma Ejekam 1,  
 
1
Department of Community Medicine. Lagos University teaching hospital, Idi-Araba, Lagos state, Nigeria
2
Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, University of Lagos, Idi-Araba, Lagos State, Nigeria
3
Department of Preventive Medicine and Public Health, and Department of Family Medicine, University of Kansas Medical Center. Kansas City, KS. USA
Tob. Prev. Cessation 2016;2(January):2
Publish date: 2016-01-29
Submission date: 2015-12-08
Final revision date: 2016-01-22
Acceptance date: 2016-01-23
KEYWORDS:
TOPICS:
 
ABSTRACT:
Introduction:
Community pharmacists are well-positioned to support smoking cessation particularly in low and middle income countries. This study aims to assess the attitudes, barriers and pattern of pharmacist-led smoking cessation services and explore the factors associated with the willingness to offer smoking cessation services.

Methods:
A cross-sectional descriptive study was carried out using qualitative and quantitative methods. Two hundred and forty two community pharmaceutical premises were randomly selected and interviewed. In addition, one Focus Group Discussion was carried out among nine members of the state branch of the Association of Community Pharmacists of Nigeria in Lagos state.

Results:
Approximately 92% had ever encountered smokers in the course of their work however only 49.6% had ever inquired of their smoking status and 49.1% had offered some form of cessation support. Only 44% had NRT’s available within their pharmaceutical premises. Majority (68.5%) were willing to offer smoking cessation services in their premises however only 44.6% had ever received any prior training on tobacco cessation. Those who believed that pharmacists had the required training to offer smoking cessation services were more willing to provide these services. Qualitative findings also revealed that majority felt they had a unique role to play in providing tobacco cessation services.

Conclusions:
These pharmacists were willing to provide smoking cessation services within their practice, however they may require specific training to do so effectively. In developing guidelines for community based smoking cessation, it is recommended that pharmacists be engaged and trained for the provision of smoking cessation services within the community.

CORRESPONDING AUTHOR:
Oluwakemi Ololade Odukoya   
Department of Community Medicine. Lagos University teaching hospital, Idi-Araba, Lagos state, Nigeria, Ishaga road, 12003 Idi-araba, Nigeria
 
REFERENCES:
1. World Health Organisation. The top 10 causes of death. Availableat http://www.who.int/mediacentre/factsheets/fs310/en/index2.html. (accessed June 2015).
2. World Health Organisation. Tobacco fact sheet. Available at http://www.who.int/mediacentre/factsheets/fs339/en/. (accessed June 2015).
3. US Department of Health and Human Services. (2004). The healthconsequences of smoking: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 62.
4. Center for disease control. Health Effects: Smoking and Tobacco use.www.cdc.gov/tobacco/basic_information/health_effects/ (accessed February 2015).
5. Federal Ministry of Health. Global Adult tobacco Survey 2012Country report. Available at: http://www.nigerianstat.gov.ng/pages/download/157 (accessedJune 2014).
6. US Department of Health and Human Services. (2004). The healthconsequences of smoking: a report of the Surgeon General. Atlanta,GA: US Department of Health and Human Services, Centers forDisease Control and Prevention, National Center for ChronicDisease Prevention and Health Promotion, Office on Smoking andHealth, 62.
7. US Department of Health and Human Services. Treating tobaccouse and dependence. A Report of the Surgeon General. Rockville,MD: Agency for Healthcare Research Quality. 2000.
8. Use, Tobacco, and Dependence Guideline Panel. “Treating tobaccouse and dependence: 2008 update.” (2008).
9. Fiore, M. C. (2000). US public health service clinical practiceguideline: treating tobacco use and dependence. Respiratorycare, 45(10), 1200-1262.
10. World Health organization, tobacco free initiative. The role ofhealth professionals in tobacco control. WHO 2005. Available athttp://www.who.int/tobacco/resources/publications/wntd/2005/bookletfinal_20april.pdf. (accessed June 2015).
11. World Health organization. The role of the pharmacist in the healthcare system. WHO 1994.
12. Beyeler N., Liu J., Sieverding M. (2015) A Systematic Review ofthe Role of Proprietary and Patent Medicine Vendors in HealthcareProvision in Nigeria. PLoS ONE 10(1): e0117165. doi:10.1371/journal.pone.0117165).
13. Pharmaceutical services negotiating committee. CommunityPharmacy- at the heart of public health. Available at http://psnc.org.uk/wp content/uploads/2013/08/Community_Pharmacy_at_the_heart_of_public_health_V1.pdf . (accessed June 2015).
14. Saba, M., Diep, J., Saini, B., & Dhippayom, T. (2014). Metaanalysis ofthe effectiveness of smoking cessation interventions in communitypharmacy. Journal of Clinical Pharmacy and Therapeutics, 39(3),240-247. doi: 10.1111/jcpt.12131.
15. Mohamed, S. S. E., Mahmoud, A. A., & Ali, A. A. (2013). Involvementof Sudanese community pharmacists in public health activities. International Journal of Clinical Pharmacy, 35(3), 393-400. doi: 10.1007/s11096-012-9745-9.
16. Kristina, S. A., Thavorncharoensap, M., Pongcharoensuk, P., &Prabandari, Y. S. (2014). Impact of smoking cessation trainingfor community pharmacists in Indonesia. Asian Pacific Journal ofCancer Prevention, 16(8), 3319-3323. doi: 10.7314/apjcp.2015.16.8.3319.
17. Nimpitakpong, P., Chaiyakunapruk, N., & Dhippayom, T. (2010). Anational survey of training and smoking cessation services providedin community pharmacies in Thailand. Journal of CommunityHealth, 35(5), 554-559.
18. Brandys, J., Panas, M., Skowron, A., & Urbaczka, A. (2008).Assessment of the effectiveness of pharmacists’ activities intreatment of tobacco-addicted patients in the context of pharmacists’counselling in Cracow’s pharmacies .Przeglad Lekarski, 66(10),836-840.
19. Fiore M. C., Jaen, C. R., Baker, T. B., Bailey, W. C., Benowitz, N. L.,Curry, S. E. E. A., Dorfman, S. F. & Wewers, M. E. (2008). Treatingtobacco use and dependence: 2008 update.
20. Tremblay, M., Comtois, D., & O’Loughlin, J. (2013). Pharmacists’Smoking Cessation Counseling Practices: A Comparison between2005 and 2010. Nicotine & Tobacco Research, 15(12), 2114-2119. doi: 10.1093/ntr/ntt118.
21. National institute for health research. An introduction to qualitativeresearch. Available at http://www.rds-yh.nihr.ac.uk/wp-content/uploads/2013/05/5_Introduction-to-qualitative-research-2009.pdf.(ccessed January 2016).
22. Aina, B. A., Onajole, A. T., Lawal, B. M., & Oyerinde, O. O. (2009).Promoting cessation and a tobacco free future: willingness ofpharmacy students at the University of Lagos, Nigeria. TobaccoInduced Diseases, 5(1), 1-8. doi: 10.1186/1617-9625-5-13.
23. Stead, L. F., Perera, R., Bullen, C., Mant, D., & Lancaster, T. (2008).Nicotine replacement therapy for smoking cessation. CochraneDatabase Syst Rev,1(1). doi: 10.1002/14651858.CD000146.pub3.
24. Tremblay, M., Cournoyer, D., & O’Loughlin, J. (2009). Do the correlates of smoking cessation counseling differ across healthprofessional groups? Nicotine & Tobacco Research, 11(11), 1330-1338. doi: 10.1093/ntr/ntp142.
25. Abdullah, A. S. M., & Husten, C. G. (2004). Promotion of smokingcessation in developing countries: a framework for urgent publichealth interventions. Thorax, 59(7), 623-630. doi:10.1136/thx.2003.018820.
26. Saba M, Diep J, Bittoun R, & Saini B. (2014). Provision of smokingcessation services in Australian community pharmacies: a simulatedpatient study. International Journal of Clinical Pharmacy. Jun1;36(3):604-14. doi:10. 1007/ s11096-014-9944-7.
27. Simansalam S., Brewster J. M., & Mohamed M. H. (2015). TrainingMalaysian pharmacy undergraduates with knowledge and skills onsmoking cessation. American journal of pharmaceutical education.Jun 25; 79(5). doi:10.5688/ajpe79571.
28. Maguire, T. A., McElnay, J. C., & Drummond, A. (2001). Arandomized controlled trial of a smoking cessation interventionbased in community pharmacies. Addiction, 96(2), 325-331. doi: 10.1046/j.1360-0443.2001.96232516.x.
29. Cantor, S. B., Deshmukh, A. A., Luca, N. S., Nogueras-Gonzalez,G. M., Rajan, T., & Prokhorov, A. V. (2015). Cost-effectivenessanalysis of smoking-cessation counseling training for physicians andpharmacists. Addictive Behaviors, 45, 79-86. doi:10.1016/j.addbeh.2015.01.004.
30. Khan, N., Anderson, J. R., D. u., J., Tinker, D., Bachyrycz, A. M., &Namdar, R. (2012). Smoking cessation and its predictors: resultsfrom a community-based pharmacy tobacco cessation program inNew Mexico. Annals of Pharmacotherapy, 46(9), 1198-1204. doi: 10.1007/s13142-014-0288-6.
31. Ashley, M. J., Brewster, J. M., & Victor, J. C. (2005). Pharmacists’smoking cessation practices: relationship to their knowledge andskills, attitudes, and perceptions of roles. Journal of the American Pharmacists Association, 46(6), 729-737. doi:10.1331/1544-3191.46.6.729.
32. Sinclair, H. K., Bond, C. M., & Stead, L. F. (2004). Communitypharmacy personnel interventions for smoking cessation. TheCochrane Library. doi: 10.1002/14651858.CD003698.pub2.
33. Kennedy, D. T., Giles, J. T., Chang, Z. G., Small, R. E., & Edwards,J. H. (2001). Results of a smoking cessation clinic in communitypharmacy practice. Journal of the American PharmaceuticalAssociation (Washington, DC: 1996), 42(1), 51-56. doi: 10.1331/108658002763538071.
34. Sinclair, H. K., Bond, C. M., Lennox, A. S., Silcock, J., Winfield, A.J., & Donnan, P. T. (1998). Training pharmacists and pharmacy assistants in the stage-of-change model of smoking cessation: a randomized controlled trial in Scotland. Tobacco Control, 7(3), 2. 53-261. doi:10.1136/tc.7.3.253
35. El Hajj M. S., Kheir N., Al Mulla A. M., Al-Badriyeh D., Al KaddourA., Mahfoud Z. R., Salehi M., & Fanous N. (2015) Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial. Trials. Feb 26;16(1):65. doi: 10.1186/s13063-015-0570-z.
36. Bock, B. C., Hudmon, K. S., Christian, J., Graham, A. L., & Bock,F. R. (2010). A tailored intervention to support pharmacy-based counseling for smoking cessation. Nicotine & Tobacco Research. doi: 10.1093/ntr/ntp197.
37. Saba M., Bittoun R., & Saini B. (2013). A Workshop on SmokingCessation for Pharmacy Students. American Journal of Pharmaceutical Education. Nov 12;77(9). doi:10.5688/ajpe779198.
38. Hughes, J. R., Shiffman, S., Callas, P., & Zhang, J. (2003).A meta-analysis of the efficacy of over-the-counter nicotine replacement. Tobacco Control, 12(1), 21-27. doi:10.1136/tc.12.1.21.
39. Kilfoy, B. A., Prokhorov, A. V., & Hudmon, K. S. (2005). Pharmacyplacement of nonprescription nicotine replacement therapy products and community pharmacists’ counseling for product use. Journal of the American Pharmacists Association, 46(6), 723-728. doi:10.1331/1544-3191.46.6.723.
40. Meshack, A., Moultry, A. M., Hu, S., & McAlister, A. L. (2009).Smoking cessation counseling practices of Texas pharmacists. Journal of Community Health, 34(3), 231-238. doi: 10.1007/s10900-008-9146-0.
41. Dent, L. A., Harris, K. J., & Noonan, C. W. (2009). Tobaccotreatment practices of pharmacists in Montana. Journal of the American Pharmacists Association, 50(5), 575-579. doi:10.1331/JAPhA.2010.10007.
42. Goniewicz, M. L., Lingas, E. O., Czogala, J., Koszowski, B., Zielinska-Danch, W., & Sobczak, A. (2009). The role of pharmacists in smoking cessation in Poland. Evaluation & The Health Professions. doi: 10.1177/0163278709356190.
43. Hudmon, K. S., Prokhorov, A. V.,& Corelli, R. L. (2006). Tobacco cessation counseling: pharmacists’ opinions and practices. Patient Education and Counseling, 61(1), 152-160. doi:10.1016/j.pec.2005.03.009.
44. Punia B. K. & Kant S. (2013). A Review of Factors Affecting Training Effectiveness vis-à-vis Managerial Implications and Future Research Directions. International Journal of Advanced Research in Management and Social Sciences. Jan;2(1):151-64.
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