1. DECLARATION OF POTENTIAL CONFLICT OF INTEREST
Pharmacy Students’ Confidence in and Knowledge of Tobacco Cessation Counseling: Hookah Tobacco vs. Cigarettes
Onyinye Nduaguba, MSPharm, Kentya H. Ford, DrPH, Benita Bamgbade, PharmD, Ogechi Iwuorie, PharmD
Health Outcomes and Pharmacy Practice Division, The University of Texas College of Pharmacy, Austin, Texas
BACKGROUND
RESULTS
RESULTS
DEMOGRAPHICS
203 (40.8%) of the students attempted the survey, of which 169 (83.3%) completed it
Majority of the respondents were female (71.01%) and white (40.24%) or Asian (38.46%)
The mean age of students who completed the survey was 25.08±3.22
Most of the students had never used cigarettes (78.11%), hookah tobacco (68.05%), electronic cigarettes (90.53%), snus (96.45%), cigarillos (86.39%), cigars (83.43%), nor smokeless tobacco (97.04%)
82% and 16% of the students reported receiving training on cigarette smoking and hookah use cessation counseling respectively
CONFIDENCE
Confidence in ability to counsel using the 5 A’s model and in overall counseling skills were moderate (3.3±0.7 and 2.9±0.7 respectively)
Students were less confident in their overall counseling skills and in their ability to counsel on hookah use cessation using the the 5 A’s model, compared to cigarette smoking cessation (p<0.01)
First year students had significantly less confidence in counseling skills for cigarette smoking cessation than second, third, and fourth year students (p<0.01)
First year students had significantly less confidence in couseling skills for hookah use cessation than second year students (p=0.03) but not with third and fourth year students (p=0.19 and p=0.45 respectively)
KNOWLEDGE
Students perceived themselves to be less knowledgeable about the effects of hookah use cessation counseling than cigarette smoking cessation counseling
42.0% of the students thought hookah tobacco was less harmful than traditional cigarettes
Tobacco use is a major risk factor for cancer, cardiovascular diseases, and respiratory illnesses. Although cigarette smoking prevalence has declined,1 use of alternative forms of tobacco is on the rise.2,3 Pharmacy schools incorporate tobacco cessation counseling training in their curricula . Training pharmacy students has been shown to improve perceived counseling skills4 but it is uncertain how this translates to ability to counsel on alternative forms of tobacco. We sought to assess pharmacy students’ confidence and knowledge in counseling, comparing commercial cigarettes and hookah tobacco.
DISCUSSION
Overall, students are receiving training on tobacco use cessation counseling
Results indicate that students may be less likely to counsel to counsel on hookah use cessation than cigarette smoking cessation
Less self-efficacy and harm misperception for hookah tobacco could translate to low priority for hookah use cessation cessation counseling in practice
Interestingly, for hookah use cessation counseling, older students , who have received training on tobacco cessation counseling, were not different from new students
This suggests that specific training is needed to address hookah use cessation counseling
OBJECTIVES
To describe student pharmacists’ perception of their knowledge about cigarette smoking and hookah use cessation
To describe student pharmacists’ perception of their confidence and ability to counsel on cigarette smoking and hookah use cessation
To compare pharmacy students’ views on cigarette smoking and hookah use cessation
CONCLUSION
Composite scores and comparisons on students’ confidence in ability to counsel on cigarette smoking cessation and hookah tobacco use cessation (n=169)
CLASS LEVEL
COMPOSITE SCORES
Confidence in Ability to Counsel Using the 5 A’s Model
Overall
Cigarette
Hookah Tobacco
t value
p value
3.3±0.7
3.4±0.7
3.1±0.9
9.07
<0.001 P1
3.4±0.9
3.5±0.9
3.2±1.0
3.24
0.002 P2
3.6±0.6
3.3±0.8
3.94 P3
3.2±0.6
3.6±0.5
2.9±0.9
5.64 P4
3.2±0.7
2.8±0.9
5.68
Confidence in General Counseling Skills
2.9±0.7
2.7±0.7
10.88
2.5±0.8
2.6±0.8
2.4±0.9
4.30
3.1±0.7
2.9±0.8
6.87
3.1±0.5
3.5±0.5
2.7±0.9
5.75
3.0±0.6
3.4±0.5
2.7±0.8
7.10
METHODS
Training of pharmacy students is still needed, especially on alternative tobacco products
If this need is filled, it can result in a boost in confidence to counsel on various forms of tobacco products
This could translate to a wider reach of tobacco users by the students when they get into practice
STUDY DESIGN AND DATA COLLECTION
A cross-sectional study was conducted in Spring 2014
Data were collected using a 34-item questionnaire-based instrument administered electronically to PharmD students (N=497)
MEASURES
Students were asked to rate their confidence in their ability to counsel using the ‘Ask-Advise-Assess-Assist-Arrange follow-up’ (5 A’s) model on a 5-point Likert scale (1=not at all confident, 2=not very confident, 3=moderately confident, 4=very confident, and 5=extremely confident)
Students were asked to rate their self-efficacy in different aspects of counseling using the aforementioned scale
Students’ perception of their knowledge of the effects of tobacco cessation counseling were also assessed on a 5-point Likert scale (1=strongly agree, 2=disagree, 3=neutral, 4=agree, and 5=strongly agree)
DATA ANALYSIS
Analyses were conducted using Statistical Analytical Software (SAS) version 9.4
DECLARATION OF POTENTIAL CONFLICT OF INTEREST
Funds for this research were provided to Dr Kentya Ford by the University of Texas at Austin College of Pharmacy and the Division of Diversity and Community Engagement
REFERENCES
Center for Disease Control and Prevention. Current cigarette smoking among adults- United States, Accessed August 21, 2014.
Connolly GN, Alpert HR. Trends in the use of cigarettes and other tobacco products, JAMA. 2008;299(22):
Bover Manderski MT, Hrywna M, Delnevo CD. Hookah use among New Jersey youth: associations and changes over time. Am J Health Behav. 2012;36(5):693-9.
Hudmon KS, Kroon LA, Corelli RL, Saunders KC, Spitz MR, Bates TR, et al. Training future pharmacists at a minority educational institution: evaluation of the Rx for change tobacco cessation training program. Cancer epidemiology, biomarkers & prevention. 2004;13(3):