Evaluation of smoking cessation training in Armenia

Abstract

Background: Healthcare providers play a central role in promoting smoking cessation. Patients getting advice from physicians are 1.6 times more likely to quit, and trained physicians are twice as likely to offer assistance to patients. This study aimed to design, implement, and evaluate the first smoking cessation training for primary healthcare physicians (PHP) in Armenia. Method(s): We recruited 58 PHPs for a two-day training (intervention group) and 51 PHPs in the control group from the two biggest cities. We utilized a quasi-experimental design to evaluate the training effectiveness using a self-administered questionnaire at baseline and 4-months follow-up. Practice score was calculated by awarding 1 point when the recommended practice was reported as being "Always" performed in physicians'' everyday work. We performed paired analysis to compare baseline and follow-up data using paired t-test and Wilcoxon test. Result(s): Overall, 105 PHPs (57-intervention, 48-control) participated in both baseline and follow-up surveys. The selfreported mean practice score significantly increased in the intervention group (10.34 vs. 14.96; p< 0.001) but not in the control group (10.03 vs. 10.25; p=0.739). The improvements from baseline to follow-up in the intervention group were observed regarding most of the selected evidence-based recommendations. However, the most vivid improvements were observed pertaining to practices in assisting patients to quit. At follow-up, more intervention group PHPs were always proposing their help to patients in quitting (45.61% vs. 85.96%, p< 0.001) and prescribing pharmacological aids such as Nicotine replacement therapy (5.36% vs. 24.56%, p< 0.001), Cytisine (1.75% vs. 24.56%, p< 0.001) and Varenicline (3.51% vs. 8.77%, p< 0.001). Conclusion(s): Training of healthcare providers can greatly improve compliance with the evidence-based smoking cessation recommendations. Similar tobacco dependence treatment trainings should be applied for all primary healthcare physicians in Armenia as well as adapted and implemented for other healthcare professional groups.