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Potential impact of a pilot training program on smoking cessation intervention for tuberculosis DOTS providers in Malaysia

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Abstract

Background

The association between tuberculosis (TB) and tobacco smoking is becoming increasingly important. Smoking cessation may yield substantial positive effects on TB treatment outcomes, relapse, and future lung disease. Thus, TB directly observed therapy, short-course (TB DOTS) providers are uniquely positioned to intervene with those TB patients who are smokers. Unfortunately, most health care professionals are inadequately trained to provide such service.

Aim

This study aimed to determine the feasibility of developing and implementing a customized training program related to the delivery of an integrated smoking cessation intervention (SCI) for TB DOTS providers and to evaluate its potential impact on their knowledge, attitudes, and perceived competence.

Method

We developed and delivered a structured training program and materials about treating tobacco use and dependence in TB settings. The training was offered to DOTS providers from six chest clinics in Penang and Wilayah Persekutuan Kuala Lumpur health districts, Malaysia, who were planned to be involved in a larger project, known as the SCIDOTS Project. A pretest-posttest survey of a single group was conducted. Changes in scores before and after the training program in knowledge and attitude were measured.

Results

Ten DOTS providers participated in the program and completed both the pretest and posttest survey questionnaire. The trainees’ median scores in knowledge of health risks of tobacco and tobacco-related diseases, the association between TB and tobacco, and overall knowledge significantly increased compared to the baseline (p < 0.05). Upon completion of the program, the majority of the trainees (70–100%) believed that they were competent and confident in performing most SCI activities.

Conclusion

This preliminary study suggests that a customized in-service training program on SCI designed for and delivered to TB DOTS providers could significantly improve their knowledge, attitude, and practice related to SCI. It has also highlighted the gap related to SCI in nursing education and calls for urgent curricula reforms.

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References

  • Amara B, El Ghazi K, Rahimi H, Elbiaze M, Nejjari C, Chakib Benjelloun M (2008) Attitudes and knowledge about smoking among Moroccan physicians looking after patients with tuberculosis (in French). Rev Mal Respir 25(5):569–575

    CAS  PubMed  Google Scholar 

  • Bates MN, Khalakdina A, Pai M, Chang L, Lessa F, Smith KR (2007) Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 167(4):335–342

    Article  PubMed  Google Scholar 

  • Chan SSC (2001) Helping patients stop smoking: the nurses’ responsibility. 6th Asia Pacific Conference on Tobacco or Health, Hong Kong

  • Chan SS, Sarna L, Wong DC, Lam TH (2007) Nurses’ tobacco-related knowledge, attitudes, and practice in four major cities in China. J Nurs Scholarsh 39(1):46–53

    Article  PubMed  Google Scholar 

  • Chatkin J, Chatkin G (2009) Learning about smoking during medical school: are we still missing opportunities? Int J Tuberc Lung Dis 13(4):429

    CAS  PubMed  Google Scholar 

  • Chiang CY, Slama K, Enarson DA (2007a) Associations between tobacco and tuberculosis. Int J Tuberc Lung Dis 11(3):258–262

    CAS  PubMed  Google Scholar 

  • Chiang CY, Slama K, Enarson DA (2007b) Tobacco use and tobacco control. Int J Tuberc Lung Dis 11(4):381–385

    PubMed  Google Scholar 

  • Davies PD, Yew WW, Ganguly D, Davidow AL, Reichman LB, Dheda K et al (2006) Smoking and tuberculosis: the epidemiological association and immunopathogenesis. Trans R Soc Trop Med Hyg 100(4):291–298

    Article  CAS  PubMed  Google Scholar 

  • Enarson DA, Slama K, Chiang CY (2007) Providing and monitoring quality service for smoking cessation in tuberculosis care. Int J Tuberc Lung Dis 11(8):838–847

    CAS  PubMed  Google Scholar 

  • Fiore MC, Bailey WC, Cohen SJ et al (2000) Treating tobacco use and dependence. Quick reference guide for clinicians. US Department of Health and Human Services, Rockville

    Google Scholar 

  • Gajalakshmi V, Peto R, Kanaka TS, Jha P (2003) Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43000 adult male deaths and 35000 controls. Lancet 362(9383):507–515

    Article  PubMed  Google Scholar 

  • Hudmon KS, Corelli RL, Chung E, Gundersen B, Kroon LA, Sakamoto LM et al (2003) Development and implementation of a tobacco cessation training program for students in the health professions. J Cancer Educ 18(3):142–149

    Article  PubMed  Google Scholar 

  • Hudmon KS, Bardel K, Kroon LA, Fenlon CM, Corelli RL (2005) Tobacco education in U.S. schools of pharmacy. Nicotine Tob Res 7(2):225–232

    Article  PubMed  Google Scholar 

  • Karine B, Chris L, Caroline M (2006) Training in tobacco cessation counseling for medical, nursing, dentistry and pharmacy students: environmental scan and recommendations. Canadian Public Health Association

  • Lin HH, Ezzati M, Murray M (2007) Tobacco smoke, indoor air pollution and tuberculosis: a systematic review and meta-analysis. PLoS Med 4(1):e20

    Article  PubMed  Google Scholar 

  • Pai M, Mohan A, Dheda K, Leung CC, Yew WW, Christopher DJ et al (2007) Lethal interaction: the colliding epidemics of tobacco and tuberculosis. Expert Rev Anti Infect Ther 5(3):385–391

    Article  PubMed  Google Scholar 

  • Reichert VC, Folan P, Bartscherer D, Jacobsen D, Fardellone C, Egglinger A et al (2008) Healthcare providers (prescribers versus nonprescribers) knowledge of tobacco-related issues including drug interactions with nicotine. Chest 134:s53003

    Google Scholar 

  • Richmond RL, Debono DS, Larcos D, Kehoe L (1998) Worldwide survey of education on tobacco in medical schools. Tob Control 7:247–252

    Article  CAS  PubMed  Google Scholar 

  • Rigotti NA, Bitton A, Richards AE, Reyen M, Wassum K, Raw M (2009) An international survey of training programs for treating tobacco dependence. Addiction 104(2):288–296

    Article  PubMed  Google Scholar 

  • Schneider NK, Novotny TE (2007) Addressing smoking cessation in tuberculosis control. Bull World Health Organ 85(10):820–821

    Article  PubMed  Google Scholar 

  • Siddiqi K, Lee AC (2009) An integrated approach to treat tobacco addiction in countries with high tuberculosis incidence. Trop Med Int Health 14(4):420–428

    Article  PubMed  Google Scholar 

  • Slama K, Chiang CY, Enarson DA (2007a) An educational series about tobacco cessation interventions for tuberculosis patients: what about other patients? Int J Tuberc Lung Dis 11(3):244

    Google Scholar 

  • Slama K, Chiang CY, Enarson DA (2007b) Helping patients to stop smoking. Int J Tuberc Lung Dis 11(7):733–738

    CAS  PubMed  Google Scholar 

  • Slama K, Chiang CY, Enarson DA (2007c) Introducing brief advice in tuberculosis services. Int J Tuberc Lung Dis 11(5):496–499

    CAS  PubMed  Google Scholar 

  • Slama K, Chiang CY, Enarson DA (2007d) Tobacco cessation and brief advice. Int J Tuberc Lung Dis 11(6):612–616

    CAS  PubMed  Google Scholar 

  • Slama K, Chiang CY, Enarson DA, Hassmiller K, Fanning A, Gupta P et al (2007e) Tobacco and tuberculosis: a qualitative systematic review and meta-analysis. Int J Tuberc Lung Dis 11(10):1049–1061

    CAS  PubMed  Google Scholar 

  • Slama K, Chiang CY, Enarson DA (eds) (2008) Tobacco cessation interventions for tuberculosis patients. A guide for low-income countries. International Union Against Tuberculosis and Lung Disease, Paris

    Google Scholar 

  • Tsung PK (2002) Nurses’ role in smoking cessation: knowledge, attitudes, and behaviors. Master’s dissertation, Hong Kong SAR, China, The University of Hong Kong

  • WHO (1997) Tobacco or health: a global status report. WHO, Geneva

    Google Scholar 

  • WHO (2008a) WHO report on the global tobacco epidemic. WHO, Geneva, pp 1–329

    Google Scholar 

  • WHO (2008b) WHO report on global tuberculosis control. Geneva

  • WHO, IUATLD (2007) A WHO/The Union monograph on TB and tobacco control. Joining efforts to control two related global epidemics, World Health Organization & International Union Against Tuberculosis and Lung Disease

  • Yach D (2000) Partnering for better lung health: improving tobacco and tuberculosis control. Int J Tuberc Lung Dis 4(8):693–697

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The SCIDOTS Project is supported by a research grant awarded by the Institute for Health Management of the National Institute of Health, Ministry of Health, Malaysia. The authors greatly appreciate this. We are thankful to all of the DOTS providers who actively participated in the training and the larger project.

Conflict of interest

The authors have no competing interests to declare.

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Correspondence to Ahmed Awaisu.

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Awaisu, A., Mohamed, M.H.N., Noordin, N.M. et al. Potential impact of a pilot training program on smoking cessation intervention for tuberculosis DOTS providers in Malaysia. J Public Health 18, 279–288 (2010). https://doi.org/10.1007/s10389-009-0302-5

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  • DOI: https://doi.org/10.1007/s10389-009-0302-5

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