Tobacco Use and Provision of Tobacco Dependence Treatment Among Respiratory Therapists in Saudi Arabia

Abstract

Background. Smoking in Saudi Arabia is on the rise, despite the various steps taken by the government to reduce tobacco use. This suggests an urgent need for healthcare professionals, such as respiratory therapists (RTs), to play a proactive role in initiatives aimed at controlling tobacco use. Guided by literature and health behavior theory, we conducted research among RTs in Saudi Arabia to (1) determine the prevalence and correlates of current tobacco use, (2) examine correlates of intention to provide tobacco cessation counseling, and (3) pilot a tobacco cessation training program tailored for RTs in Saudi Arabia. Methods. We collected online cross-sectional survey data on tobacco use and cessation behaviors and beliefs from a convenience sample of RTs in Saudi Arabia recruited using social media in April to June 2022. Following the completion of the survey, we tailored a training program in tobacco cessation counseling and assessed its effect on knowledge and behaviors through a pilot study with a convenience sample of RTs recruited from hospitals in Saudi Arabia using social media in November 2022 to March 2023. Regression models were fit to the survey data to examine factors associated with tobacco use and intention to provide cessation counseling. To describe changes in beliefs and behaviors following training completion, we used descriptive statistics due to the pilot nature of the study. Results. The final analytic sample was 202 RTs. The majority of respondents were male, married, held a bachelor’s degree, and worked in Riyadh. Overall, the highest prevalence of current use was for e-cigarettes (20.8%, SE 5.8%), followed by waterpipe (17.3%, SE 5.6%), and cigarettes (17.0%, SE 5.5%). Current cigarette smoking was associated with female gender (PR 0.13, 95% CI 0.03 – 0.51), current e-cigarette use was associated with female gender (PR = 0.28, 95% CI 0.12 – 0.68) and relative harm of e-cigarette (PR = 0.73, 95% CI 0.58 – 0.93), and current waterpipe smoking was associated with relative harm of waterpipe smoking (PR 0.49, 95% CI 31 – 0.78). Additionally, intention to provide cessation counseling to tobacco users was associated with having a bachelor’s (β = 2.66, SE = 1.20, p = 0.03) or postgraduate (β = 2.61, SE = 1.28, p = 0.04) degree compared to an associate degree, and higher perceived behavioral control (β = 1.22, SE = 0.38, p < 0.01). Of the 8 RTs who completed the training program, all reported higher favorable attitudes toward, subjective norms of, perceived behavioral control of, and intentions to providing tobacco cessation counseling. Additionally, they reported lower perceived barriers, higher knowledge of tobacco dependence treatment, and higher frequency of delivering brief cessation counseling behaviors. Conclusion. The findings from this research can be leveraged to establish new and refine existing policies and interventions to further reduce the burden of tobacco use among Saudi RTs and the general population and improve delivery of tobacco cessation counseling among Saudi RTs. This research serves as a foundation for future research examining the impact of tobacco cessation training on Saudi RTs’ counseling behaviors.