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Smoking cessation training for foundation year doctors: a positive step towards a smoke-free society

Ebony Farnell, Scarlett Tankard and Nyuk Cho Lee
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DOI: https://doi.org/10.7861/fhj.9-2-s76
Future Healthc J July 2022
Ebony Farnell
AWrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
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Scarlett Tankard
AWrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
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Nyuk Cho Lee
AWrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK
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Introduction

Tobacco smoking is a leading cause of preventable death and disability.1 Despite a significant decrease in smoking prevalence over recent years, considerable work is required to achieve the government ambition of a smoke-free society in England by 2030.2,3 Targeted intervention is required to increase the quit rate among established smokers.1 Every presentation to a health service represents an opportunity to offer smoking cessation advice and appropriate therapy, with even brief input shown to support a significant factor in initiating a service user's attempt to quit.1 As such, all healthcare professionals must be adequately trained to provide such support.1,4 Many undergraduate medical students do not receive sufficient training in the evidence-based means to facilitate smoking cessation among patients, this continues following qualification with a limited emphasis in many postgraduate curricula.1 This study assessed the use of practical smoking cessation training, incorporating role-play scenarios, on foundation year doctors’ confidence when delivering smoking cessation advice and treatment.

Materials and methods

Smoking cessation training was provided to a cohort of foundation year one doctors (n=18) in a UK teaching hospital. The training included didactic lecture-style learning, small group discussions and role-play scenarios. Quantitative and qualitative data were collected using structured feedback forms and self-reported confidence ratings (1–10) before and immediately following the described training session. Quantitative data were analysed using paired t-test scores, to determine whether a statistically significant difference existed between mean confidence ratings before and after the educational session. Qualitative data were analysed with deductive thematic analysis.

Results and discussion

Over half (55.55%; n=10) of the group received formal training during their undergraduate degree. Despite this, foundation year doctors attributed a lack of awareness, training, and knowledge as perceived barriers to independently offering smoking cessation advice and prescription of nicotine replacement therapy (NRT) to patients.

A large proportion of the cohort (72.22%; n=13) reported assessing patients’ smoking status on a daily or weekly basis. In comparison, the majority (77.77%; n=14) reported rarely or never offering advice, or prescribing NRT to established smokers. Pre-session self-reported confidence ratings demonstrated poor trainee confidence when providing smoking cessation advice (4.44±2.23) or prescribing treatment (4.61±2.17). Following the session, self-reported confidence ratings increased across all areas assessed. Firstly, when providing smoking cessation advice (8.33±1.24): a statistically significant increase of 3.89 (95% confidence interval (CI) 2.84–4.94), t(17) =7.8148, p<0.0001, d=0.498. Secondly, when prescribing treatment (8.64±1.05): a statistically significant increase of 4.03 (95% CI 3.16–4.89; t(17)=9.8432; p<0.0001; d=0.409). The small group, practical and role-play learning style was well received by trainees, who reported that this enhanced awareness and knowledge of the subject matter.

Conclusion

The implementation of smoking cessation training that incorporates a mix of teaching modalities, including role-play scenarios, improves the confidence of foundation year doctors providing advice and treatment to established smokers. Such activity presents a meaningful opportunity to improve newly qualified clinicians’ ability to support the quit attempts of their patients, a positive step on the road to a smoke-free society.

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. Royal College of Physicians
    . Hiding in plain sight: Treating tobacco dependency in the NHS. London: RCP, 2018. www.rcplondon.ac.uk/projects/outputs/hiding-plain-sight-treating-tobacco-dependency-nhs [Accessed 7 February 2022].
  2. ↵
    1. Public Health England
    . Health matters: Stopping smoking – what works? PHE. www.gov.uk/government/publications/health-matters-stopping-smoking-what-works/health-matters-stopping-smoking-what-works [Accessed 7 February 2022].
  3. ↵
    1. Lewis P
    . Smoke-free England by 2030: on track or unrealistic? https://lordslibrary.parliament.uk/smoke-free-england-by-2030-on-track-or-unrealistic/ [Accessed 7 February 2022].
  4. ↵
    1. Royal College of Physicians
    . Smoking and health 2021: a coming of age for tobacco control? London: RCP, 2021. www.rcplondon.ac.uk/projects/outputs/smoking-and-health-2021-coming-age-tobacco-control [Accessed 7 February 2022].
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Smoking cessation training for foundation year doctors: a positive step towards a smoke-free society
Ebony Farnell, Scarlett Tankard, Nyuk Cho Lee
Future Healthc J Jul 2022, 9 (Suppl 2) 76; DOI: 10.7861/fhj.9-2-s76

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Smoking cessation training for foundation year doctors: a positive step towards a smoke-free society
Ebony Farnell, Scarlett Tankard, Nyuk Cho Lee
Future Healthc J Jul 2022, 9 (Suppl 2) 76; DOI: 10.7861/fhj.9-2-s76
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