Journal of Community Health

, Volume 35, Issue 5, pp 554–559 | Cite as

A National Survey of Training and Smoking Cessation Services Provided in Community Pharmacies in Thailand

  • Piyarat Nimpitakpong
  • Nathorn Chaiyakunapruk
  • Teerapon Dhippayom
Original Paper


Over the past few years, several training programs have been run in support of smoking cessation services within community pharmacy circles in Thailand. These have included a comprehensive training program offered by the Thai Pharmacy Network for Tobacco Control (TPNTC) and brief training programs run by other agencies. This study provides an estimate of the scale of smoking cessation activities among Thai pharmacies, and examines the impact of both the brief and comprehensive training programs on the provision of smoking cessation services. A self-administered questionnaire was mailed to 3,600 Thai community pharmacists. A total of 1,001 questionnaires were returned (response rate: 27.8%). Smoking cessation services were provided by 71.1% of the respondents, and 47.4% of such services gave only brief advice. Comprehensive services (defined by the 5A’s: ask, advise, assess, assist, and arrange follow-up) accounted for 15.3% of the respondents. Only 293 pharmacists (29.6%) said they had received cessation training; 62.5% of whom had received such training from TPNTC. The receipt of brief and comprehensive training was associated with a higher rate of the provision of brief advice, when compared with no training, showing adjusted odds ratios (ORs) of 2.93 (95% CI, 1.66–5.18) and 5.93 (95% CI, 3.18–10.17) respectively, while evidence of differences between these training programs was not observed, having an adjusted OR of 1.94 (95% CI, .89–4.21). TPNTC trained pharmacists were 4.98 times (95% CI, 2.24–11.05) more likely than those who received other brief training to provided the 5A’s cessation services. All types of training program help to promote the provision of brief counseling by pharmacists. Comprehensive training is associated with the increased provision of both 4A’s and 5A’s cessation services.


Smoking cessation Training program 5A Brief advice Community pharmacy 


  1. 1.
    Doll, R. (2000). Fifty years of research on tobacco. Journal of Epidemiology and Biostatistics, 5, 321–329.PubMedGoogle Scholar
  2. 2.
    Ezzati, M., Lopez, A. D., Rodgers, A., Vander Hoorn, S., & Murray, C. J. (2002). Selected major risk factors and global and regional burden of disease. Lancet, 360, 1347–1360.CrossRefPubMedGoogle Scholar
  3. 3.
    Rasmussen, S. R., Prescott, E., Sorensen, T. I., & Sogaard, J. (2005). The total lifetime health cost savings of smoking cessation to society. European Journal of Public Health, 15, 601–606.CrossRefPubMedGoogle Scholar
  4. 4.
    Quist-Paulsen, P., Lydersen, S., Bakke, P. S., & Gallefoss, F. (2006). Cost effectiveness of a smoking cessation program in patients admitted for coronary heart disease. European Journal of Cardiovascular Prevention and Rehabilitation, 13, 274–280.CrossRefPubMedGoogle Scholar
  5. 5.
    Miller, M., & Wood, L. (2003). Effectiveness of smoking cessation interventions: Review of evidence and implications for best practice in Australian health care settings. Australian New Zealand Journal of Public Health, 27, 300–309.CrossRefGoogle Scholar
  6. 6.
    Mojica, W. A., Suttorp, M. J., Sherman, S. E., Morton, S. C., Roth, E. A., Maglione, M. A., et al. (2004). Smoking-cessation interventions by type of provider: A meta-analysis. American Journal of Preventive Medicine, 26, 391–401.CrossRefPubMedGoogle Scholar
  7. 7.
    de Vries, H., Bakker, M., Mullen, P. D., & van Breukelen, G. (2006). The effects of smoking cessation counseling by midwives on Dutch pregnant women and their partners. Patient Education and Counseling, 63, 177–187.CrossRefPubMedGoogle Scholar
  8. 8.
    Thavorn, K., & Chaiyakunapruk, N. (2008). A cost-effectiveness analysis of a community pharmacist-based smoking cessation programme in Thailand. Tobacco Control, 17, 177–182.CrossRefPubMedGoogle Scholar
  9. 9.
    Anderson, C. (2000). Health promotion in community pharmacy: The UK situation. Patient Education and Counseling, 39, 285–291.CrossRefPubMedGoogle Scholar
  10. 10.
    Maguire, T. A., McElnay, J. C., & Drummond, A. (2001). A randomized controlled trial of a smoking cessation intervention based in community pharmacies. Addiction, 96, 325–331.CrossRefPubMedGoogle Scholar
  11. 11.
    Zillich, A. J., Ryan, M., Adams, A., Yeager, B., & Farris, K. (2002). Effectiveness of a pharmacist-based smoking-cessation program and its impact on quality of life. Pharmacotherapy, 22, 759–765.CrossRefPubMedGoogle Scholar
  12. 12.
    Tran, M. T., Holdford, D. A., Kennedy, D. T., & Small, R. E. (2002). Modeling the cost-effectiveness of a smoking-cessation program in a community pharmacy practice. Pharmacotherapy, 22, 1623–1631.CrossRefPubMedGoogle Scholar
  13. 13.
    Kennedy, D. T., Giles, J. T., Chang, Z. G., Small, R. E., & Edwards, J. H. (2002). Results of a smoking cessation clinic in community pharmacy practice. Journal of American Pharmaceutical Association, 42, 51–56.CrossRefGoogle Scholar
  14. 14.
    Sinclair, H. K., Bond, C. M., & Stead, L. F. (2004). Community pharmacy personnel interventions for smoking cessation. Cochrane Database of Systematic Reviews, 1, CD003698.Google Scholar
  15. 15.
    Thananithisak, C., Nimpitakpong, P., & Chaiyakunapruk, N. (2008). Activities and perceptions of pharmacists providing tobacco control services in community pharmacy in Thailand. Nicotine & Tobacco Research, 10, 921–925.CrossRefGoogle Scholar
  16. 16.
    Meredith, L. S., Yano, E. M., Hickey, S. C., & Sherman, S. E. (2005). Primary care provider attitudes are associated with smoking cessation counseling and referral. Medical Care, 43, 929–934.CrossRefPubMedGoogle Scholar
  17. 17.
    Garg, A., Serwint, J. R., Higman, S., Kanof, A., Schell, D., Colon, I., et al. (2007). Self-efficacy for smoking cessation counseling parents in primary care: An office-based intervention for pediatricians and family physicians. Clinical Pediatrics, 46, 252–257.CrossRefPubMedGoogle Scholar
  18. 18.
    Kotz, D., van Litsenburg, W., van Duurling, R., van Schayck, C. P., & Wesseling, G. J. (2008). Smoking cessation treatment by Dutch respiratory nurses: Reported practice, attitudes and perceived effectiveness. Patient Education and Counseling, 70, 40–49.CrossRefPubMedGoogle Scholar
  19. 19.
    Twardella, D., & Brenner, H. (2005). Lack of training as a central barrier to the promotion of smoking cessation: A survey among general practitioners in Germany. European Journal of Public Health, 15, 140–145.CrossRefPubMedGoogle Scholar
  20. 20.
    Schnoll, R. A., Rukstalis, M., Wileyto, E. P., & Shields, A. E. (2006). Smoking cessation treatment by primary care physicians: An update and call for training. American Journal of Preventive Medicine, 31, 233–239.CrossRefPubMedGoogle Scholar
  21. 21.
    Lancaster, T., Silagy, C., & Fowler, G. (2000). Training health professionals in smoking cessation. Cochrane Database of Systematic Reviews CD000214.Google Scholar
  22. 22.
    Aquilino, M. L., Goody, C. M., & Lowe, J. B. (2003). WIC providers’ perspectives on offering smoking cessation interventions. American Journal of Maternal Child Nursing, 28, 326–332.CrossRefPubMedGoogle Scholar
  23. 23.
    Chan, S. S. C., Sarna, L., Wong, D. C. N., & Lam, T.-H. (2007). Nurses’ tobacco-related knowledge, attitudes and practice in four major cities in China. Journal of Nursing Scholarship, 39, 46–53.CrossRefPubMedGoogle Scholar
  24. 24.
    Borrelli, B., Lee, C., & Novak, S. (2008). Is provider training effective? Changes in attitudes towards smoking cessation counseling and counseling behaviors of home health care nurses. Preventive Medicine, 46, 358–363.CrossRefPubMedGoogle Scholar
  25. 25.
    Thai Pharmacy Network for Tobacco Control. (2008). Annual report 2007 to Thai Health Promotion Foundation. Bangkok.Google Scholar
  26. 26.
    Office of Pharmacy Advancement Project. (2009). Annual Report 2009. Bangkok: Thai Drug Control Division.Google Scholar
  27. 27.
    Williams, D. M., Newsom, J. F., & Brock, T. P. (2000). An evaluation of smoking cessation-related activities by pharmacists. Journal of American Pharmaceutical Association, 40, 366–370.Google Scholar
  28. 28.
    Couchenour, R. L., Denham, A. Z., Simpson, K. N., Lahoz, M. R., & Carson, D. S. (2000). Smoking cessation activities in South Carolina community pharmacies. Journal of American Pharmaceutical Association, 40, 828–831.Google Scholar
  29. 29.
    Aquilino, M. L., Farris, K. B., Zillich, A. J., & Lowe, J. B. (2003). Smoking-cessation services in Iowa community pharmacies. Pharmacotherapy, 23, 666–673.CrossRefPubMedGoogle Scholar
  30. 30.
    Supawong, C. (2007). Two decades of tobacco control in Thai society (Thai). Bangkok: Tobacco Control Research and Knowledge Management Center.Google Scholar
  31. 31.
    (2006). Pharmacy collaboration to diminish smoking across Thailand. Pharmatime, 4:24–30.Google Scholar
  32. 32.
    World Health Organization. WHO framework convention on tobacco control. [Online]. 2005 [cited 2009 Mar 9]; [42 pages]. Available from:
  33. 33.
    Trotter, L., & Worcester, P. (2003). Training for dentists in smoking cessation intervention. Australian Dental Journal, 48, 183–189.CrossRefPubMedGoogle Scholar
  34. 34.
    von Garnier, C., Kochuparackal, S., Miedinger, D., Leuppi, J. D., Tamm, M., Battegay, E., et al. (2008). Smoking cessation advice: Swiss physician lack training. Cancer Detection and Prevention, 32, 209–214.CrossRefGoogle Scholar
  35. 35.
    McRobbie, H., Hajek, P., Feder, G., & Eldridge, S. (2008). A cluster-randomised controlled trial of a brief training session to facilitate general practitioner referral to smoking cessation treatment. Tobacco Control, 17, 173–176.CrossRefPubMedGoogle Scholar
  36. 36.
    Allen, B., Jr., Pederson, L. L., & Leonard, E. H. (1998). Effectiveness of physicians-in-training counseling for smoking cessation in African Americans. Journal of the National Medical Association, 90, 597–604.PubMedGoogle Scholar
  37. 37.
    Cornuz, J., Humair, J. P., Seematter, L., Stoianov, R., van Melle, G., Stalder, H., et al. (2002). Efficacy of resident training in smoking cessation: A randomized, controlled trial of a program based on application of behavioral theory and practice with standardized patients. Annals of Internal Medicine, 136, 429–437.PubMedGoogle Scholar
  38. 38.
    Kifoy, B. A., Prokhorov, A. V., & Hudmon, K. S. (2006). Pharmacy placement of nonprescription nicotine replacement therapy products and community pharmacists’ counseling for product use. Journal of American Pharmaceutical Association, 46, 723–728.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Piyarat Nimpitakpong
    • 1
    • 2
  • Nathorn Chaiyakunapruk
    • 1
    • 2
    • 3
  • Teerapon Dhippayom
    • 1
    • 4
  1. 1.Faculty of Pharmaceutical Sciences, Department of Pharmacy PracticeNaresuan UniversityPhitsanulokThailand
  2. 2.Center of Pharmaceutical Outcome Research (CPOR)Naresuan UniversityPhitsanulokThailand
  3. 3.School of Population HealthThe University of QueenslandBrisbaneAustralia
  4. 4.Faculty of Pharmaceutical Sciences, Pharmaceutical Care Research UnitNaresuan UniversityPhitsanulokThailand

Personalised recommendations