Practice of smoking cessation counselling and its associated factors among government primary healthcare workers in Perak: a cross-sectional study

Introduction: Primary healthcare workers are in a strategic position to promote smoking cessation due to their accessibility. This study aimed to determine smoking cessation counselling (SCC) practice among primary healthcare workers and identify its associated factors. Methods: A cross-sectional online survey was conducted among 363 primary healthcare workers in all government healthcare clinics in the districts of Hilir Perak, Kerian, Kinta, Larut, Matang and Selama, and Manjung from January to June 2023. Doctors, allied health professionals, pharmacists, medical assistants, and nurses were included. Knowledge, attitude, and practice of SCC were assessed using a validated 22-items questionnaire that covered 5 As (ask, advise, assess, assist and, arrange) and 5 Rs (relevance, risks, rewards, roadblocks and, repetitions). Multiple logistic regression was used to analyse the factors associated with poor practice. Results: Most participants were doctors (31.1% ), followed by allied health professionals (21.8%), pharmacists (19.3%), medical assistants (14.3%), and nurses (13.5%). The majority showed poor practice (93.7%), knowledge (94.8%), and attitude (51.5%). Only 16.8% were trained in SCC. Multivariate logistic regression analysis revealed that only the district was significantly associated with poor counselling practice. Hilir Perak district showed the highest odds of having poor practice (adjusted odds ratio (aOR)=17.80, 95% confidence interval (CI)=2.02–156.97, P-value=0.01). However, the prevalence of poor practice among the other districts was also high (77.0% –97.8%). Conclusion: SCC practice, knowledge, and attitude are poor among Perak’s government primary healthcare workers. The district-specific differences suggest that localized studies should be considered to determine the influential factors.

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