Pharmaceutical care provision by Malaysian community pharmacists via smoking cessation services

Tobacco use and dependence is a major public health issue. In Malaysia, 46% of adults are current smokers and about 10,000 die annually from tobacco-related diseases. Smoking cessation has been accepted as a crucial strategy in tobacco control to reduce the incidence and impact of a range of costly chronic diseases, improve health-related quality of life and yield savings in health care cost. Evidence has consistently demonstrated the effectiveness of various health professional-based smoking cessation interventions. Community pharmacists have the golden opportunity to deliver smoking cessation services as they have regular contact with area residents and are usually very accessible. From 2004-2008, more than 600 community pharmacists were trained to provide smoking cessation services via the Certified Smoking Cessation Service Provider (CSCSP) program. The program provides pharmacists with the additional knowledge and skills as part of the pharmaceutical care plan of their clients. The CSCSP includes training on having a systematic identification and documentation of smoking status; provision of a personalized and supportive advice on smoking cessation; an assessment a smoker's interest in quitting and level of nicotine dependence; and the provision of appropriate therapy with self help materials and scheduled 10-15 minutes follow-up visits. Knowledge, attitude and practice (KAP) assessments were done pre and post-training. Training improved almost all aspects of the KAP parameters. However, barriers such as reimbursement issues, monitoring, documentation and reporting exist. The certification program for smoking cessation services equips Malaysian community pharmacists with the knowledge and skills to address tobacco use and dependence issues as part of pharmaceutical care provision.