On the front line of smoking cessation: Pharmacists' practices and self-perception

Background: Pharmacists can be effective in helping patients to quit smoking, and opportunities for such interaction have been facilitated by legislative change making nicotine replacement therapy (NRT) available without prescription in Canada. However, there are no previous studies of Canadian pharmacists' preparation for, perception of, or practices regarding their roles in smoking cessation. Methods: Practising community pharmacists in four Canadian provinces were surveyed about their tobacco-related education and knowledge, practice environment, perceptions of their roles and practices related to helping people quit smoking, and factors perceived to facilitate tobacco-related practice. Results: A corrected response rate of 72% was obtained, giving a weighted n of 960 responses. Most pharmacists reported good or excellent knowledge of the health effects of smoking and the use of NRT in smoking cessation. Fewer reported being knowledgeable about behavioural approaches to quitting smoking. Advising patients about NRT was seen as a more important role for pharmacists than giving patients pamphlets or behavioural counselling. Pharmacists' reported practices corresponded to their knowledge and judged importance of roles; pharmacists were not proactive in approaching patients about smoking, but when smokers were identified, pharmacists gave brief advice about the use of NRT. Respondents reported that their smoking cessation practice was facilitated by their own knowledge and skills, patients' interest in quitting, opportunities for patient interaction, and the support of pharmacy management for patient counselling. Conclusions: Improving pharmacist education in patient counselling and behavioural approaches to smoking cessation would help to develop skills in initiating discussions about smoking and would give pharmacists a wider range of options to help patients quit smoking.