Situation on Bringing Smokers with Non-communicable Diseases to Smoking Cessation Clinic

Abstract

Objectives: To study the situation on bringing smokers with non-communicable diseases (NCDs) to smoking cessation service within the hospitals in Phayao according to the 5A principle (ask, advise, assess, assist, arrange follow-up). Methods: This research was a qualitative study collecting the data using in-depth interview. Two groups of informants included healthcare providers working in smoking cessation clinics and NCD patients in 8 hospitals in Phayao affiliated with Ministry of Public Health. Main focus of the interview was on process on smoking cessation of the hospitals in NCD patients, Results: Hospitals in the study provided smoking cessation service in psychiatric clinics, 4 out of 8 clinics were Pharsai clinic. NCD patients were treated similarly to general patients within the hospitals. Access to smoking cessation clinics was gained in 3 channels, including screening from various departments in the hospital, screening from the District Health Promotion Hospital and voluntary request of the service by patients. Health staff convinced the patients to stop smoking and refer them to the hospital's smoking cessation clinic. Patients under the treatment received consultation, drugs and follow up until 1 year. The most commonly medications received by patients were mouthwash, nortriptyline, Vernonia cinerea tea and vitamin C, respectively. The process of advising patients to quit smoking followed well-accepted practice principles. However, the budget problem has implications for hospital drug programs and the continuity of patient treatment with some modification to fit the context of the hospitals. However, the budgetary problem affected the availability of drugs within the hospitals and continuity in patient treatment. Setting some performance indicators of treatment outcomes and monitoring of patient during hospital visit may lead to ineffective assessment. Although there were some restriction in service provision, NCD patients receiving the service were still satisfied with the quit smoking service provided by their hospital. Conclusion: The studied hospitals provided the services according to all principles delineated within the 5A. However, some hospitals had no medication for smoking cessation. Further study should focus on the development of monitoring system after treatment, promotion of the service to improve accessibility and service redesign to become one-stop service NCD clinic.