Knowledge, attitudes and practices of front-line physicians in smoking cessation assistance in Sfax, Tunisia, in 2020

Introduction: first-line physicians should play a key role in tobacco control. The purpose of this study is to assess the knowledge and attitudes of front-line physicians as well as their practices for smoking cessation, assess their smoking status and determine the barriers to smoking cessation support. Methods: we conducted a cross-sectional study among a representative sample of front-line physicians practising in the governorate of Sfax in November 2020. Results: a total of 115 first-line physicians were included in the study, with a sex ratio (M/F) of 0.91 and an average age of 43 years (interquartile interval= [34-55 years]). Among the respondents, 26 (22.6%) stated that they were smokers; 98 of the physicians surveyed (85.2%) had not had any postgraduate training in smoking cessation. However, 71 (61.7%) had an idea on nicotine replacement therapy. Regarding attitudes,73 respondents (63.5%) were convinced that physicians were responsible for helping their patients quit smoking. Forty five physicians (39.1% ) systematically asked all patients about their smoking habits. The least performed activities of the 5A strategy were the components "help" (14%) and "organize follow-up" (17.4%). Patients' disinterest was considered (53%) to be a significant barrier to smoking cessation assistance by the 61 physicians surveyed. Conclusion: there is a need to evaluate and improve the implementation of the national tobacco control strategy, in particular with regard to the training of front-line physicians.