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Smoking cessation knowledge, attitudes and barriers among junior doctors at Middlemore Hospital

Smoking cessation knowledge, attitudes and barriers among junior doctors at Middlemore Hospital

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Smoking cessation knowledge, attitudes and barriers among junior doctors at Middlemore Hospital

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  1. Smoking cessation knowledge, attitudes and barriers among junior doctors at Middlemore Hospital Dr Sandra Hotu RESPIRATORY TRAINEE

  2. introduction

  3. background Successful smoking cessation programmes • Identify smokers • Providers are knowledgeable about behavioural and pharmacologic treatment techniques • Providers are confident about their abilities to intervene

  4. Hypothesis • Junior doctors lack the confidence and competence to provide effective smoking cessation interventions due to • Lack of training • Certain attitudes and beliefs • There are multiple barriers to effective provision of smoking cessation interventions

  5. methods

  6. Methods • 258 junior doctors • Adult inpatient and emergency department care • Middlemore Hospital • 950 Beds • Population 490,000 • Electronic and paper surveys • Voluntary and anonymous

  7. Questionnaire • Demographics • Training and knowledge • Attitudes and beliefs • Barriers to providing smoking cessation interventions

  8. results 158/258 respondents: 61%

  9. DEMOGRAPHICS

  10. Demographics

  11. Demographics

  12. Demographics

  13. Demographics

  14. Demographics

  15. TRAINING

  16. training Training

  17. Training

  18. KNOWLEDGE

  19. KNOWLEDGE • Perceived competence in providing SCC

  20. Knowledge based on specialty • Perceived competence in providing SCC

  21. Knowledge • How often do you ask patients if they smoke?

  22. Knowledge • How often do you advise patients to stop smoking?

  23. Knowledge based on specialty • How often do you advise patients to stop smoking?

  24. Knowledge • How often do you prescribe cessation medication?

  25. Knowledge based on specialty • How often do you prescribe cessation medications?

  26. Knowledge • How confident are you in prescribing cessation medication?

  27. Knowledge based on specialty • How confident are you in prescribing cessation medication?

  28. Knowledge • For patients who would like more support, how often do you make a referral to cessation services?

  29. ATTITUDES AND BELIEFS

  30. Attitudes and beliefs

  31. Attitudes and beliefs

  32. Attitudes and beliefs

  33. Attitudes and beliefs

  34. BARRIERS

  35. Barriers

  36. Key findings

  37. Key findings • TRAINING • Less than half had received training • More pronounced in PGY >3/Registrars • Medical school, Intern orientation • KNOWLEDGE • Adequate – ask, advise • Inadequate- prescribe, refer to services • Higher levels if • Smoking cessation training • Medical Registrars • Tobacco-related illness

  38. Key findings • ATTITUDES AND BELIEFS • Lack of strong belief in professional responsibility and effectiveness of SC interventions • Consultants lacked encouragement • BARRIERS • Lack of time • Language barriers • Perception that patients are not interested • Forget

  39. recommendations

  40. RECOMMENDATIONS • SMOKING CESSATION TRAINING • Compulsory, updates • All specialties • All levels including consultants • ATTITUDES AND BELIEFS • Smoking Cessation Training • My input helps patients to stop smoking • Feedback from smoking cessation services • Consultant important role model • BARRIERS • Lack of time • 5 minutes for ABC if competent • Accessible resources • Chart reminders • Interpreting services

  41. Limitations • Size • Response rate • Specialty associations • SMOs not included in scope of study

  42. Acknowledgements • Asthma Foundation • Stuart Jones • Conroy Wong • CMDHB Respiratory Medicine Department • Irene Zeng, • CMDHB Smoking cessation services

  43. REFERENCES Aveyard P, West R. 2007. Managing smoking cessation. British Medical Journal 335(7609): 37-41 Doll R, Peto R, Boreham J, Sutherland I. 2004. Mortality in relation to smoking: 50 years observations on male British doctors. British Medical Journal 328: 1519 Flay BR, Phil D, Ockene JK, Tager IB. Smoking: epidemiology, cessation, and prevention. Chest. 1992; 102(3 Suppl):277S-301S Goldberg RJ, Ockene JK, Kristeller J, Kalan K, Landon J, Hosmer DW. Factors associated with heavy smoking among men and women: The Physician-Delivered Smoking Intervention Project. Am Heart J.1993;125:818-23 Hepburn MJ, Johnson JM, Ward JA, Longfield JN. A survey of smoking cessation knowledge, training, and practice among US Army general medical officers. Am J Prev Med. 2000 May;18(4):300-4 KrupskiWC et al. Smoking cessation counselling: a missed opportunity for general surgery trainees. J Vasc Surg. 2002 Aug;36(2):257-62; discussion 262 Lancaster T, Fowler G. 2000. Training health professionals in smoking cessation. Cochrane Database Systematic Reviews (3):Art no: CD000214. DOI:10.1002/14651858 Marlow SP, Stoller JK. Smoking cessation. Respir Care. 2003:48(12):1238-54; discussion 1254-6 Ministry of Health. 2014. Tobacco Use 2012/13: New Zealand Health Survey. Wellington: Ministry of Health. 1aMinistry of Health. 2010. Tobacco Use in New Zealand: Key findings from the 2009 New Zealand Tobacco Use Survey. Wellington: Ministry of Health. ProchazkaA, Koziol-McLain J, Tomlinson D, Lowenstein SR. Smoking Cessation Counseling by Emergency Physicians: Opinions, Knowledge, and Training Needs. Academic Emergency Medicine. 1995 Mar;4(3):211-5 Pursell R, Galland RB. Do specialist registrars fail smokers? Ann R CollSurg Engl. 2005 May;87(3):196-8 Schroeder SA. 2006. Should emergency physicians help smokers quit? Annals of Emergency Medicine, 48, 415-416 RigottiN, Munafo MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD001837. DOI: 10.1002/14651858.CD001837.pub2