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Abstract

Background: Thailand implemented the FAH-SAI Clinic smoking cessation service program in 2010, which provides services through a multidisciplinary team. However, the contribution of each healthcare professional in terms of activity frequency and time spent has not been formally assessed, and the appropriate incentive compensation needs to be evaluated.

Method: We performed a prospective observational study, focusing on individuals aged 13 and above who were in the action stage. We utilized an activities-based approach and work points system to measure time contribution and calculate incentive compensation. Data were collected through a paper/electronic case record form and questionnaire. Descriptive statistics were used to report the outcomes.

Results: Our study analyzed 2,041 participants and 4,098 visits, which reported 37,356 frequencies across 10 activities provided by healthcare professionals in smoking cessation clinics following the 5 As model. Nurses had the highest frequency of contributions (N of activity=23,979; 64.19%). Public health technical officers spent time the most with an average of 27.74 minutes. The top three professionals receiving incentive compensation per case were public health technical officers at 31.67 Baht, followed by nurses at 28.41 Baht, and physicians at 21.74 Baht.

Conclusion: All healthcare professionals play important roles in smoking cessation service program with varying contributions based on time, frequency, and activities involved. To implement these findings, it is important to consider the performance of each setting and involve non-study stakeholders.

Keywords: Smoking cessation clinic, Tobacco control, Smoking cessation, Thailand

References

[1] World Health Organization [WHO]. WHO report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies. Geneva: WHO; 2017.

[2] World Health Organization [WHO]. WHO report on the global tobacco epidemic 2021: addressing new and emerging products. Geneva: WHO; 2021.

[3] World Health Organization [WHO]. Tobacco. [cited 2022 October 1]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco

[4] World Health Organization [WHO]. WHO report on the global tobacco epidemic, 2019: offer help to quit tobacco use. Geneva: WHO; 2019.

[5] Coste J, Quinquis L, D'Almeida S, Audureau E. Smoking and health-related quality of life in the general population. Independent relationships and large differences according to patterns and quantity of smoking and to gender. PLoS One. 2014; 9(3): e91562. doi: 10.1371/journal.pone.0091562

[6] Gowing LR, Ali RL, Allsop S, Marsden J, Turf EE, West R, et al. Global statistics on addictive behaviours: 2014 status report. Addiction. 2015; 110(6): 904-19. doi: 10.1111/add.12899

[7] Heikkinen H, Jallinoja P, Saarni SI, Patja K. The impact of smoking on health-related and overall quality of life: a general population survey in Finland. Nicotine Tob Res. 2008; 10(7): 1199-207. doi: 10.1080/14622200802163142

[8] Mons U, Muezzinler A, Gellert C, Schottker B, Abnet CC, Bobak M, et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium. BMJ. 2015; 350: h1551. doi: 10.1136/bmj.h1551

[9] National Center for Chronic Disease Prevention, Health Promotion Office on Smoking Health. Reports of the Surgeon General. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Reports of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2014.

[10] Vogl M, Wenig CM, Leidl R, Pokhrel S. Smoking and health-related quality of life in English general population: implications for economic evaluations. BMC Public Health. 2012; 12(1): 203. doi: 10.1186/1471-2458-12-203

[11] West R. Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychol Health. 2017; 32(8): 1018-36. doi: 10.1080/08870446.2017.1325890

[12] Li IC, Lee SY, Chen CY, Jeng YQ, Chen YC. Facilitators and barriers to effective smoking cessation: counselling services for inpatients from nurse-counsellors' perspectives--a qualitative study. Int J Environ Res Public Health. 2014; 11(5): 4782-98. doi: 10.3390/ijerph110504782

[13] Pagano A, Tajima B, Guydish J. Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs. J Subst Abuse Treat. 2016; 67: 22-9. doi: 10.1016/j.jsat.2016.04.004

[14] Zapka J, Goins KV, Pbert L, Ockene JK. Translating efficacy research to effectiveness studies in practice: lessons from research to promote smoking cessation in community health centers. Health Promot Pract. 2004; 5(3): 245-55. doi: 10.1177/1524839904263713

[15] World Health Organization [WHO]. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: WHO; 2013.

[16] Vathesatogkit P, Charoenca N. Tobacco control: lessons learnt in Thailand. Indian J Public Health. 2011; 55(3): 228-33. doi: 10.4103/0019-557X.89938

[17] National Alliance for Tobacco-Free Thailand. A summary of SMART Quit Clinic Program: 4 years report. Bangkok; National Alliance for Tobacco-Free Thailand; 2011. [in Thai].

[18] Chaisai C, Chaiyakunapruk N, Thavorn K, Wattanasirichaigoon S, Rungruanghiranya S, Thongphiew A, et al. Assessment of the real-world impact of the Thai smoking cessation programme on clinical outcomes: protocol for a multicentre prospective observational study. Prim Health Care Res Dev. 2022; 23: e71. doi: 10.1017/S1463423622000548

[19] National Health Security Office. Thailand Handbook of Pay for Performance : P4P. [cited 2022 October 15]. Available from: http://bps.moph.go.th/new_b74ps/sites/default/files/p4p.PDF.

[20] Agency for Healthcare Research and Quality. Five Major Steps to Intervention (The "5 A's"). [updated 2012 December; cited 2022 October 1]. Available from: https://www.ahrq.gov/prevention/guidelines/tobacco/5steps.html

[21] Martin-Cantera C, Sanmartín JMI, Martínez AF, Lorenzo CM, Cohen VB, Jiménez MLC, et al. Good practice regarding smoking cessation management in Spain: Challenges and opportunities for primary care physicians and nurses. Tob Prev Cessat. 2020; 6: 55. doi: 10.18332/tpc/126630

[22] van Rossem C, Spigt MG, Kleijsen JR, Hendricx M, van Schayck CP, Kotz D. Smoking cessation in primary care: Exploration of barriers and solutions in current daily practice from the perspective of smokers and healthcare professionals. Eur J Gen Pract. 2015; 21(2): 1-7. doi: 10.3109/13814788.2014.990881

[23] Vogt F, Hall S, Marteau TM. General practitioners' and family physicians' negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005; 100(10): 1423-31. doi: 10.1111/j.1360-0443.2005.01221.x

[24] Young JM, Ward JE. Implementing guidelines for smoking cessation advice in Australian general practice: opinions, current practices, readiness to change and perceived barriers. Fam Pract. 2001; 18(1): 14-20. doi: 10.1093/fampra/18.1.14

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