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AUB), a leading institution of higher education in Lebanon and the region, with an affiliated tertiary medical center, developed one of the first smoking-cessation programs in the country in 2015 in response to an identified need within the university community 4,5 .

Background: While cigarette smoking has been considered the most relevant tobacco product worldwide, waterpipe tobacco smoking (WTS) has increased in prevalence globally and calls for more considerable attention now. However, little is known about WTS cessation knowledge and clinical practices among physicians, particularly in Lebanon. This study aims to examine the knowledge, barriers, and cessation practices of primary care practitioners towards WTS. Methods: A cross-sectional study where an anonymous self-reported questionnaire was completed by physicians attending the Annual Conference of the Lebanese Society of Family Medicine for family medicine physicians, general practitioners, and internists in Lebanon. Results: Out of 180 attendees, 105 primary care practitioners (PCPs) responded to the questionnaire. Only 38.1% of the physicians think similar techniques are used for the cessation of smoking of both cigarette and waterpipe. Similarly, 30.5% of the physicians believe that nicotine replacement therapy works in the cessation of waterpipe smoking. There was a statistically significant difference between the percentage of physicians who counsel for cigarette smoking and those who counsel for waterpipe smoking cessation (p = 0.005) where 30% of the physicians tend to counsel against cigarette smoking more than waterpipe smoking. Conclusions: This study shows a difference in the attitude and behavior of PCPs towards cigarette and waterpipe smoking cessation. Moreover, there is a lack of knowledge about water pipe smoking cessation techniques. There is a great room for continued medical education to PCPs in their private practice to improve their knowledge.

ObjectiveTo assess awareness and attitudes towards engaging in advance care planning (ACP) and their relationship with demographic, socioeconomic and religiosity factors among Lebanese middle-aged to older-aged adults in primary care.DesignA cross-sectional survey study.SettingTertiary referral hospital in Beirut, Lebanon.ParticipantsA total of 215 middle-aged to older-aged adults.ResultsOut of 215 participants, 18.6% of participants knew about ACP; 94% favoured truth-telling; 87.4% favoured healthcare autonomy; 77.2% favoured documenting their own health values and preferences; and 29.3% were willing to undergo life-prolonging interventions. Among participants who were aware of ACP, 67.5% preferred ACP documentation and 85% had negative attitudes towards life-sustaining interventions. Women were more aware about ACP than men. Those who were willing to undergo life-prolonging interventions were found to be men and had higher religiosity scores.ConclusionLarge deficit in ACP awareness was evident despite the high preference for healthcare autonomy. Medical and public health efforts should strive to enhance patients’ ACP awareness and engagement in ACP while considering factors relevant to gender, culture and religiosity.

Introduction: Almost one-third of the Lebanese population are active smokers, with limited knowledge about their attitudes toward existing smoking cessation interventions. This study aims at exploring the facilitators and barriers facing a smoking cessation program (SCP) in a Lebanese tertiary referral center from the providers’ perspective. Materials and Methods: This is a qualitative study comprising a focus group discussion (FGD) among five practitioners from the SCP. The data collected were then transcribed and summarized by coding, simplifying, and transforming the raw data into major themes and subthemes as per the Miles and Huberman method of organization. Results: Facilitators and barriers fell under three subthemes: (1) participant factors, (2) provider factors, and (3) system factors. Facilitators included motivation and concerns about health among patients, in addition to increased behavioral support from providers. Meanwhile, barriers were much predominant and included stress factors and nicotine addiction among patients, time constraints among providers, lack of an effective referral system, inaccessibility, and unavailability of pharmacotherapy as well as a pro-smoking environment with weakly enforced tobacco legislation. Conclusion: Our findings implicate the need for multilevel strategies to help improve smoking cessation interventions. Addressing identified barriers is of paramount importance to help develop effective, accessible, and culturally specific tobacco treatment.