Examining physicians' preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states.

BACKGROUND A total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown. AIMS The study aimed to examine the primary care physicians' preparedness to deliver tobacco cessation services in two Indian states. METHOD Researchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians' preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program. RESULTS Overall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3%) and on-the-job training (18.9%). Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system. CONCLUSION The study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.