Knowledge, Attitudes And Practices Of Medical Doctors On Pharmacotherapy For Smoking Cessation In Khomas Region, Namibia

ABSTRACT

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower and middle income countries (LMIC). Inspite that smoking cessation (SC) pharmacotherapy significantly reduces poor outcome, access to smoking cessation services in medical practice in Namibia is unknown. The study aims to assess the knowledge, attitudes and practice of SC pharmacotherapy among medical doctors in Khomas region, Namibia. A cross-sectional analytic study design was conducted among medical practitioners in private and public settings in Khomas region. Data on knowledge, attitudes and practice of SC pharmacotherapy were collected from stratified samples of private and public medical doctors using a self-administered questionnaire and analysed through SPSS v23 for inferential and descriptive quantitative analysis and associations using Chi-squared test and T-test. A total of 106 doctors participated; majority (60%) were general medical practitioners, 73(69%) practiced in public facilities, 40% were of the age category 30-40 years and 99.1% were non-smokers. Out of the 71(66%) doctors who offer smoking cessation services, 25% had good knowledge on the SC pharmacotherapy, 93% provide SC counselling services and 32% prescribe SC medications. Nicotine replacement therapy (53%) and Bupropion slow release (41%) are the most prescribed SC medications. Doctors in the private sector had better knowledge (p=0.011) and prescribed (p=0.007) SC pharmacotherapy more frequently than in the public sector. Majority 93(88%) of the doctors, had excellent attitude towards SC pharmacotherapy. Main barriers to provision of SC pharmacotherapy were – lack of competence and/or policy framework. The study concludes that despite the good attitude towards SC pharmacotherapy, knowledge and practice remains limited among medical practitioners particularly in the public sector. There is a need for a policy frame work for the provision of SC services and pharmacotherapy as part of the essential primary health care (PHC) package.