Investigation On Abilities Of Smoking Cessation Services And Its Associated Factors Among General Practitioners In Shanghai

Objective The aim of our research is to know smoking prevalence and the abilities of providing smoking cessation services among general practitioners in community health centers of Shanghai, to analyze the associated factor, and to provide scientific evidence for improving the ability of smoking control service.Methods A cross-sectional survey among all499general practitioners practicing in17community health centers of Shanghai was conducted in February2013to assess general practitioners’ knowledge, attitudes, beliefs, confidence and usual practices in relation to smoking cessation. Subjects’ knowledge on smoking cessation was assessed by asking10questions (Appendix). A scoring system was developed from these10questions, in which1point was assigned for each correct response or agree response and0for each incorrect or uncertain response or disagree response. Respondents scoring a mean score or above were categorized as having better knowledge and those scoring below the mean were categorized as having poor knowledge. Attitudes on smoking cessation practice were assessed by asking8questions (Appendix). A scoring system was developed from these8questions, in which1point was assigned for each agree response and0for each uncertain response or disagree response. Respondents scoring a mean score or above were categorized as having positive attitudes and those scoring below the mean were categorized as having negative attitudes.Results1. Primary outcomes. Of the499respondents (96.9%response rate),38.1%were male,82.6%were non-smokers and74.9%had received no basic training on smoking cessation. Less than half of the doctors did not hold adequate knowledge (44.5%) or favorable attitudes (39.3%) towards smoking cessation. Doctors who hold adequate knowledge were more likely to be aged below40years, with less than20years’ practice experience, trained in Western medicine, non-or ex-smokers, with the basic training on smoking cessation and high level of education (p<0.05). Doctors who hold positive attitudes or beliefs were more likely to be aged below40years, with less than10years’ practice experience, trained in Western medicine, with the basic training on smoking cessation and with adequate knowledge towards smoking cessation (p<0.05).2. Secondary outcomes.①The minority (17.4%) of GPs was smokers, with almost half (46.2%) of all male GPs and0.3%female GPs. The male GPs’ current smoking prevalence rates were33.3%. GPs that hold high current smoking rates were more likely to be aged above50years and low level of education.②39.4%were less confident in their smoking cessation skills. GPs that hold adequate knowledge or favorable attitudes towards smoking cessation were more confident in their smoking cessation skills.③Coctors who gave smoking cessation advice were more likely to be with more positive attitudes or beliefs towards smoking cessation (p<0.001).④The result of Logistic regression showed that factors associated with knowledge and attitudes in relation to smoking cessation included department that the GPs working at, as well as the basic training on smoking cessation.Conclusions The survey provided a lot of evidence for cessation intervention in primary care of Shanghai. It has shown that existing smoking cessation service provision in community health centers for patients who smoke is inadequate, the GPs’ consciousness of controlling smoking are absent and has identified a lack of smoking cessation skills among GPs. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers to quit smoking. However, larger sample size study is needed to confirm our conclusion.