Attitudes et connaissances des pneumo-phtisiologues marocains vis-à-vis du tabagisme chez leurs patients tuberculeux

Facteurs associés à la tuberculose chez l’enfant au Centre Hospitalier Universitaire Mère-Enfant de Tsaralalàna, Antananarivo: une étude cas-témoins

“…Suivant de nombreuses études réalisées sur ce sujet, telles que celle de Bates et celle d'Amara, le rapport existant entre le tabagisme passif de l'enfant et la survenue de tuberculose s'avère bien connu [ 33 , 34 ]. Dans notre série, le tabagisme passif est présent chez 58% des cas et chez 46,24% des témoins, soit 1,62 fois plus de risque par rapport aux non-exposés.…”

A narrative review of facilitators and barriers to smoking cessation and tobacco-dependence treatment in patients with tuberculosis in low- and middle-income countries

“…• Structural (institutional) factors -lack of impact of health education sessions, lack of extramural activities when on hospital admission, lack of access to smoking cessation interventions (unaware of any available aids to stop smoking or NRT), easy access to cigarettes within a hospital setting (from staff, peers, visitors, shops close to hospital, hospital café) 44 • Non-addiction-related personal barriers -lack of knowledge about quit strategies, lack of willpower to quit, psychosocial stress, peer smokers' influence Barriers for HW to provide BSS: institutional lack of resources (insufficient space, high patient load, no reporting/recording of tobacco, overwork) and an absence of professional support through monitoring and evaluation 48 Possible barriers to smoking cessation/TDT -patients'/staff's knowledge, attitudes Lack of resources (human, financial), low level of education of health providers on smoking cessation 21 Beliefs that smoking is fun, calms nerves, relieves all life stresses 23 Stigma (especially in women to admit using tobacco) 26,48 Tolerance of smoking or snuff dipping at a health centre by medical assistants providing SCI, smoking staff 30 Not considering low-to-moderate level smokers to be real smokers, particularly those who have reduced their smoking from one to two packs a day to just a few sticks 41 Less knowledge that smoking increases risk of stroke and heart attack 36…”

“…Socio-cultural influences (i.e. family/friends smokers) 26 Brief advice focused only on smoking could lead to a higher rate of SLT relapse seen as a form of harm reduction 29 Receiving a disease-specific cessation message -associated with a lower likelihood of smoking relapse 40 Perception of low-moderate level smoking as harmless 41 Period of follow-up: increase in relapses within the 6 months of treatment and within the 3-6 months following treatment [40][41][42] Several barriers were connected to the healthcare system itself: limited space and privacy at the clinics 37 , lack of coordination between the TB treatment programme and tobacco cessation 39,43 , lack of resources (human, financial), low level of education of health providers on smoking cessation 21 , tolerance of smoking or snuff dipping at a health centre by medical assistants providing SCI, and smoking staff 30 .…”

“…Regarding HW, barriers to provide BSS were as follows: institutional lack of resources (insufficient space, high patient load, no reporting/recording of tobacco, overwork), an absence of professional support through monitoring and evaluation 48 or misclassification of current smokers as former smokers at the time of TB diagnosis (= quit smoking at the onset of TB symptoms) 34 . Low level of education of health providers on smoking cessation 21 , e.g. relying on the fact that the diagnosis of TB alone will lead to a more significant decrease in the prevalence of smoking among patients with TB 47 , and decrease of initial enthusiasm for counselling over the longterm 46 , may be barriers to provide SCI.…”

Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit

“…Healthcare professionals dealing with TB in developing nations sometimes advise patients with TB about smoking less [143,144] and in one study only 5% believed they were sufficiently trained in smoking cessation techniques [146]. Furthermore, smoking cessation pharmacotherapy is less available and relatively expensive for use on a large scale in developing countries.…”