Barriers to the provision of smoking cessation intervention/services: A mixed-methods study among health care workers in Zambezi region, Namibia


Submitted: 22 July 2021
Accepted: 25 April 2022
Published: 1 March 2023
Abstract Views: 550
PDF: 228
HTML: 3
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Background. Healthcare workers (HCWs) can play a signifi- cant role in tobacco prevention by delivering smoking cessation (SC) interventions to patients who smoke.

Objective: To identify and explore the perceived barriers which prevent healthcare workers from delivering SC counselling to patients in Zambezi region, Namibia.

Methods: A regional-based, concurrent mixed-methods study was conducted between March and October 2020 among HCWs of the 8 constituencies of Zambezi region, Namibia. In the study, 129 respondents, who had been residents of the selected constituencies for over 5 years and aged between 17 to 60 years, participated.

Results: 129 respondents participated in the study. Majority of respondents were females (62.9% and 68.1%) compared to (37.1% and 31.9%) males. The mean age of respondents was 35.91 (SD=9.3) and 36.61 (SD=8.7) respectively and their ages ranged between 18 and 59 years. Key barriers were identified: (i) HCWs- based barriers included lack of time to provide SC, inadequate training and insufficient knowledge on SC interventions; (ii) sys- tem-based barriers identified lack of SC guidelines and educational materials for patients, and specialists to refer patients; and (iii) patient/client-based barriers included lack of patient interest in SC information, patients not adhering to advise given on SC.

Conclusions: This study showed that SC delivery in Zambezi region is inadequate. Barriers were identified regarding the deliv- ery of SC intervention for the first time. Targeted SC interventions are required to combat these identified specific barriers. There is a crucial need to improve HCWs skills and knowledge in providing SC intervention.


World Health Organization. WHO report on the global tobacco epidemic, 2008: the MPOWER package; 2008. Available from: https://books.google.com/books?hl=en&lr=&id=y6YsDwAAQBAJ&oi=fnd&pg=PA7&dq=22.%09World+Health+Organization,+%26+Research+for+International+Tobacco+Control.+(2008).+WHO+report+on+the+global+tobacco+epidemic,+2008:+the+MPOWER+package.+World+Health+Organization.&ots=Y5Ux4IGoeV&sig=jbmDZagWf5LSvmLTysggxai5hqg Accessed on: July 16 2018.

U.S. Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the surgeon general; 2010. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53012/ Accesed on: February 18 2020.

McIvor A, Kayser J, Assaad JM, et al. Best practices for smoking cessation interventions in primary care. Can Respir J 2009;16:129-34. DOI: https://doi.org/10.1155/2009/412385

Yach D. WHO framework convention on tobacco control. Lancet 2003;361:611-2. DOI: https://doi.org/10.1016/S0140-6736(03)12532-9

The state of global tobacco control.

Jradi H. Awareness, practices, and barriers regarding smoking cessation treatment among physicians in Saudi Arabia. J Addict Dis 2017;36:53-9. DOI: https://doi.org/10.1080/10550887.2015.1116355

Caplan L, Stout C, Blumenthal DS. Training physicians to do office-based smoking cessation increases adherence to PHS Guidelines. J Community Health 2011;36:238-43. DOI: https://doi.org/10.1007/s10900-010-9303-0

McMenamin SB, Bellows NM, Halpin HA, et al. Adoption of policies to treat tobacco dependence in U.S. medical groups. Am J Prev Med 2010;39:449-56. DOI: https://doi.org/10.1016/j.amepre.2010.07.009

Amakali K, Haoses L, Itembu L, et al. Tobacco smoking among University of Namibia students: behaviors, reasons, attitudes, awareness & knowledge of associated health risks. J Med Med Sci Res 2013.

Sreeramareddy CT, Pradhan PM, Sin S. Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries. BMC Med 2014;12:243. DOI: https://doi.org/10.1186/s12916-014-0243-x

Namibia Statistics Agency. 2011 POPULATION AND HOUSING CENSUS. 2011.

Commission np. Republic of namibia national planning commission Namibia Poverty Mapping Macroeconomic Planning Department. 2015.

Doyle L, Brady A-M, Byrne G. An overview of mixed methods research. J Res Nurs 2009;14:175-85. DOI: https://doi.org/10.1177/1744987108093962

Hadi MA, Alldred DP, Closs SJ, Briggs M. Mixed-methods research in pharmacy practice: basics and beyond (part 1). Int J Pharm Pract 2013;21:341–5. DOI: https://doi.org/10.1111/ijpp.12010

Chisha Z, Ataguba J. Smoking inequality and health expenditures: a case study of Namibia. Tob Induc Dis 2018;16(1). DOI: https://doi.org/10.18332/tid/83922

Kyu HH, Georgiades K, Boyle MH. Maternal smoking, biofuel smoke exposure and child height-for-age in seven developing countries. Int J Epidemiol 2009;38:1342-50. DOI: https://doi.org/10.1093/ije/dyp253

Peltzer K, Pengpid S. Concurrent alcohol and tobacco use among school-going adolescents in Namibia: prevalence and risk factors. J Psychol Africa 2018;0237:141-6. DOI: https://doi.org/10.1080/14330237.2018.1455317

Tam J, van Walbeek C. Tobacco control in namibia: the importance of government capacity, media coverage and industry interference. Tob Control 2014;23:518-23. DOI: https://doi.org/10.1136/tobaccocontrol-2012-050725

Peter TR. The effect of proximity to the northern Namibian borders on smoking prevalence among Namibian men versity e Tow versity e To w; 2016. Available from: https://open.uct.ac.za/bitstream/handle/11427/20481/thesis_com_2016_peter_tuyenikeumbo_rose..pdf?sequence=1&isAllowed=y

Young JM, Ward JE. Implementing guidelines for smoking cessation advice in Australian general practice: opinions, current practices, readiness to change and perceived barriers. Fam Pract 2001;18:14-20. DOI: https://doi.org/10.1093/fampra/18.1.14

Mejia R, Pérez Stable EJ, Kaplan CP, et al. Effectiveness of an intervention to teach physicians how to assist patients to quit smoking in argentina. Nicotine Tob Res 2016;18:1101-9. DOI: https://doi.org/10.1093/ntr/ntv153

Salinas GD, Williamson JC, Kalhan R, et al. Barriers to adherence to chronic obstructive pulmonary disease guidelines by primary care physicians. Int J COPD 2011;6:171-9. DOI: https://doi.org/10.2147/COPD.S16396

Meijer E, Van Der Kleij RMJJ, Chavannes NH. Facilitating smoking cessation in patients who smoke: A large-scale cross-sectional comparison of fourteen groups of healthcare providers. BMC Health Serv Res 2019;19:1-16. DOI: https://doi.org/10.1186/s12913-019-4527-x

Jordan TR, Dake JA, Price JH. Best practice for smoking cessation in pregnancy: do obstetrician/gynecologists use them in practice? J Women’s Heal 2006;15:400-11. DOI: https://doi.org/10.1089/jwh.2006.15.400

Brotonsc C, Björkelund C, Bulc M, et al. Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med 2005;40:595-601. DOI: https://doi.org/10.1016/j.ypmed.2004.07.020

Panaitescu C, Moffat MA, Williams S, et al. Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians. NPJ Prim Care Respir Med 2014;24:24. DOI: https://doi.org/10.1038/npjpcrm.2014.22

Park ER, Gareen IF, Japuntich S, et al. Primary care provider-delivered smoking cessation interventions and smoking cessation among participants in the national lung screening trial. JAMA Intern Med 2015;175:1509–16. DOI: https://doi.org/10.1001/jamainternmed.2015.2391

Billington DR, Chan-Kam J, Harrington P, et al. Encouraging stopping smoking preface. Available from: https://www.elitedating.be/wp-content/uploads/sites/49/2019/10/stop_smoking_whomsdmdp01_4.pdf

Harutyunyan A, Abrahamyan A, Hayrumyan V, Petrosyan V. Perceived barriers of tobacco dependence treatment: a mixed-methods study among primary healthcare physicians in Armenia. Prim Heal Care Res Dev 2018;20 DOI: https://doi.org/10.1017/S1463423618000828

Olanrewaju Oladimeji, Department of Public Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha

Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Botswana

Supporting Agencies

Ministry of Health and Services, Namibia

Mahoto, S. K., Mitonga, H. K., & Oladimeji, O. (2023). Barriers to the provision of smoking cessation intervention/services: A mixed-methods study among health care workers in Zambezi region, Namibia. Journal of Public Health in Africa, 14(2). https://doi.org/10.4081/jphia.2023.1992

Downloads

Download data is not yet available.

Citations