Smoking behavior and beliefs about the impact of smoking on anti-tuberculosis treatment among health care workers

Abstract

SUMMARY SETTING Tuberculosis (TB) health care facilities throughout Georgia. OBJECTIVE To describe smoking behaviors among health care workers (HCWs) at TB facilities and determine HCWs’ knowledge and beliefs regarding the impact of tobacco use on anti-tuberculosis treatment. DESIGN Cross-sectional survey from May to December 2014 in Georgia. Adult HCWs (age ≥ 18 years) at TB facilities were eligible. We administered a 60-question anonymous survey about tobacco use and knowledge of the effect of smoking on anti-tuberculosis treatment. RESULTS Of the 431 HCWs at TB facilities who participated, 377 (87.5%) were female; the median age was 50 years (range 20–77). Overall, 59 (13.7%) HCWs were current smokers and 35 (8.1%) were past smokers. Prevalence of current smoking was more common among physicians than among nurses (18.6% vs. 7.9%, P < 0.0001). Among HCWs, 115 (26.7%) believed smoking does not impact anti-tuberculosis treatment, and only 25.3% of physicians/nurses received formal training in smoking cessation approaches. Physicians who smoked were significantly more likely to believe that smoking does not impact anti-tuberculosis treatment than non-smoking physicians (aOR 5.11, 95%CI 1.46–17.90). CONCLUSION Additional education about the effect of smoking on TB treatment outcomes is needed for staff of TB health care facilities in Georgia. Nurses and physicians need more training about smoking cessation approaches for patients with TB.

A systematic review of the effectiveness of smoking cessation interventions among patients with tuberculosis

“…39,40 Training and supervision are a key requisite for integrating smoking cessation messaging into routine NTPs. 41,42 HCWs themselves may smoke and not recognize the importance of smoking cessation messages, particularly for TB patients. 30,41 In addition, even if HCWs agree with smoking cessation, they may not have adequate knowledge to provide tailored advice for TB patients.…”

“…41,42 HCWs themselves may smoke and not recognize the importance of smoking cessation messages, particularly for TB patients. 30,41 In addition, even if HCWs agree with smoking cessation, they may not have adequate knowledge to provide tailored advice for TB patients. 30,41,42 For example, one study noted that TB nurses asked patients about smoking habits and gave advice 87% of the time, but did not provide TB-specific messaging that could increase the likelihood of quitting.…”

“…30,41 In addition, even if HCWs agree with smoking cessation, they may not have adequate knowledge to provide tailored advice for TB patients. 30,41,42 For example, one study noted that TB nurses asked patients about smoking habits and gave advice 87% of the time, but did not provide TB-specific messaging that could increase the likelihood of quitting. 15 Most interventions required a 1-day training course for providers, with some utilizing a training-of-trainers approach to increase reach.…”

Smoking and cessation-related attitudes among men who have sex with men in the country of Georgia

“…MSM in this study reported cessation to be important; MSM in other lowresource settings also show interest in a broad range of cessation intervention supports . Unfortunately, doctors in many LMICs, such as China, infrequently offer cessation services and lack cessation resources (Berg, Nehl, Wang, Ding, He, Johnson, et al, 2014;Magee et al, 2017;Smith & Leggat, 2007). Indeed, one study of TB healthcare providers in Georgia indicated several barriers to providing smoking cessation support, including insufficient training in smoking cessation (Magee et al, 2017).…”

“…Unfortunately, doctors in many LMICs, such as China, infrequently offer cessation services and lack cessation resources (Berg, Nehl, Wang, Ding, He, Johnson, et al, 2014;Magee et al, 2017;Smith & Leggat, 2007). Indeed, one study of TB healthcare providers in Georgia indicated several barriers to providing smoking cessation support, including insufficient training in smoking cessation (Magee et al, 2017). Perceived or enacted stigma among MSM (Costenbader et al, 2009) or PLWH (Hatzenbuehler et al, 2013) may also be barriers to seeking or receiving cessation services.…”