Smoking Cessation Counseling: Attitude in the Background of Poor Practice Compliance among Palestinian Primary Health Care Physicians: A cross sectional study

Abstract

Background: Health-care systems have primary responsibility for treating tobacco dependence. Despite its proven effectiveness, international studies have shown that provision of 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 in the period between April to September,2019. Proportionate stratified random sampling method was used. Sociodemograpic, medical experience, if received any training in smoking cessation counseling, smoking history, practice compliance, knowledge, confidence and attitude were assessed. Results: 294 PHC physicians' participated in the study with high response rate. More than a 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 compliance to smoking cessation practice. Attitude level among the participant physicians was good as the overall attitude score mean was 75.1 ± 9.6. Positive attitude, assigned as any score ≥65, was observed in 87.7% (n=258) of physicians. Job title, experience and knowledge are predictors of positive attitude towards smoking cessation counseling.Conclusion: Building supportive environment, improving physicians’ capabilities will reflect on their self-efficacy and their con­fidence level and will improve their practice in smoking cessation counseling.