Promoting cessation and a tobacco free future: willingness of pharmacy students at the University of Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Tobacco use is projected to cause nearly 450 million deaths worldwide during the next 50 years. Health professionals can have a critical role in reducing tobacco use. Therefore, one of the strategies to reduce the number of smoking-related deaths is to encourage the involvement of health professionals in tobacco-use prevention and cessation counseling. As future health care providers, pharmacy students should consider providing assistance to others to overcome tobacco use and be involved in promoting a tobacco free future as part of their professional responsibility.</p> <p>This research was to determine the knowledge of tobacco/smoking policy, willingness to be involved in tobacco cessation, attitude to keeping a tobacco free environment and the smoking habit among pharmacy students at the University of Lagos.</p> <p>Methods</p> <p>Data was collected by the use of self administered questionnaire which was aimed at assessing their smoking habit, determining their knowledge and attitude to smoking policy and willingness to be involved in smoking cessation. The population sample was all the pharmacy students in their professional years (200 to 500 Levels) at Idi-Araba Campus of the University of Lagos.</p> <p>Results</p> <p>Out of 327 qualified participants, 297 responded to the questionnaire which was about 91% participation rate but out of these only 291 questionnaires were useful which came to 89%.</p> <p>There seemed to be no statistically significant difference between the smoking habits among the different levels (p > 0.05). Overall, the current smoking prevalence was 5.5% which is lower than the national prevalence rate of 8.9%.</p> <p>Awareness of WHO FCTC global tobacco treaty was low (9.3%) among pharmacy students but they agreed that pharmacists and pharmacy students should be involved in quit smoking program (93.1%) and they were willing to be involved in helping smokers to quit (85.9%). Majority agreed that smoking should not be permitted in pharmacies (87.9%) and at pharmacy students' events (86.9%).</p> <p>Conclusion</p> <p>From this study it can be concluded that smoking prevalence is low among pharmacy students at the University of Lagos. Awareness of global policy is low but they are willing to be involved in smoking cessation and promoting a tobacco free future.</p

An assessment of generic drug use in management of chronic diseases in Lagos State, Nigeria

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Stakeholders views on why child overweight and obesity is rising in Lagos, Nigeria: A qualitative study

Background and Objective: According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity among school children in Lagos State, Nigeria has been established, but specific factors promoting its prevalence are unknown. The aim of this study was to elicit the views of stakeholders on the perceived causes for the rise in child overweight and obesity. Methods: Five focus group discussions were conducted with different groups of stakeholders involved in child care, namely: Parents, teachers, and healthcare givers. Participants were recruited using a purposive sampling method; a structured question guide was employed for the discussion sessions. The discussions were recorded, collated, and analyzed using grounded theory to extract themes. Results: Six themes emerged as factors responsible for the rise, of which civilization and lifestyle imbalance of the populace emerged as the prominent cause. Of the fifty respondents, 76% of respondents identified parents (particularly young mothers) as major contributors to the prevalence of overweight and obesity in children of Lagos State; and 52.3% of the participants reported that a direct relationship exists between income class of parent and weight of a child resident in Lagos. Conclusion: Civilization and lifestyle imbalance, insecurity and congestion, low level of public awareness, inadequate educative and enlightenment programs, myths and societal perception were factors identified to responsible for the rise in the prevalence of child obesity in Lagos, Nigeria. Preventive strategies to control the prevalence of overweight and obesity in children residing in Lagos State should be considered for further studies

Cost implication of irrational prescribing of chloroquine in Lagos State general hospitals

Background: A major share of the hospital budget is spent on drugs. Irrational use of these drugs is a waste of financial and human resources that could have been deployed for another use within the hospital setting especially in cases where such drugs are provided free to patients. Also there is increased morbidity and progression of severity with irrational use. The objective of this study was to determine the irrational use of chloroquine and the subsequent cost implications in Lagos State general hospitals.Methodology: A retrospective study period of one year (January to December, 2000) was selected. A total of 18,781 prescription forms of “Free Eko Malaria” were sampled for children and adults from all the Lagos State general hospitals. Drug costs in each prescription form were identified. Cost effectiveness analysis of chloroquine tablet and intramuscular injection was undertaken.Results: The average cost of medicine per prescription was N 132.071 ($1.03) which should have been N 94.22 ($0.73) if prescribed rationally. The total cost of prescriptions for malaria under study was N 2,480,425.00 ($19,348.09). About 68$13,100.19)} of the total cost was lost to irrational prescribing. This is a waste of scarce resources. When the prescriptions were differentiated into the different dosage forms prescribed, the prescriptions containing intramuscular injections only had over 90% of the cost lost to irrational prescribing. Cost effectiveness analysis showed that chloroquine tablet was 17 times more cost effective than chloroquine injection (intramuscular) from a health care system perspective while it was 14 times more cost effective from a patient perspective.Conclusion: There is waste of scarce resources with irrational dispensing of drugs and these resources could have been deployed to other uses or areas within the hospitals. The tablet chloroquine was more cost effective than injection chloroquine (intramuscular). Increasing the cost of tablets, decreasing effectiveness of tablets, decreasing the cost of injections and increasing the effectiveness of injections did not change the cost effectiveness conclusion

Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria

Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies.Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria.Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria.Results: The quantitative survey revealed that the majority (72.1%) of the respondents were aged between 20 and 40 years, predominantly male (60.8%), Yoruba (50.2%) or Igbo (40.3%) ethnicity and had been practicing pharmacy for ten years or less (72.2%). A majority (90.1%) of respondents were aware that tobacco is harmful to health. Slightly less (75.8%) were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4%) and esophageal (68.9%) cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%), chronic obstructive pulmonary disease (27.8%), bladder cancer (47.2%), peripheral vascular disease (35.8%) and sudden death (31.1%). Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). A little over half of the respondents (53.8%) were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%), in public places (79.2%), and in restaurants, nightclubs and bars (73.6%). For every additional client attended to daily, knowledge scores increased by 0.022 points. Current smokers were 1.3 times less likely to support smoke-free policies compared with non-smokers. The findings emanating from the focus group discussion reinforced the fact that the pharmacists were in support of smoke-free policies particularly in homes and public places. It also demonstrated that most of them were aware of the health risks associated with tobacco use and second hand smoke however some misconceptions seemed to exist.Conclusion: The pharmacists surveyed expressed support of smoke-free policies and most of them were aware of the health risks associated with tobacco use. However, awareness of WHO FCTC and country-level tobacco legislation was low. Current smokers were less likely to support smoke-free policies. Community pharmacists should therefore be considered worth engaging for the promotion of smoke-free policies. Efforts should also be made to educate pharmacists about country level smoke-free laws

Pharmacist-led smoking cessation: The attitudes and practices of community pharmacists in Lagos state, Nigeria: A mixed methods survey

Introduction Community pharmacists are well-positioned to support smoking cessation particularly in low and middle income countries. This study aims to assess the attitudes, barriers and pattern of pharmacist-led smoking cessation services and explore the factors associated with the willingness to offer smoking cessation services. Methods A cross-sectional descriptive study was carried out using qualitative and quantitative methods. Two hundred and forty two community pharmaceutical premises were randomly selected and interviewed. In addition, one Focus Group Discussion was carried out among nine members of the state branch of the Association of Community Pharmacists of Nigeria in Lagos state. Results Approximately 92% had ever encountered smokers in the course of their work however only 49.6% had ever inquired of their smoking status and 49.1% had offered some form of cessation support. Only 44% had NRT’s available within their pharmaceutical premises. Majority (68.5%) were willing to offer smoking cessation services in their premises however only 44.6% had ever received any prior training on tobacco cessation. Those who believed that pharmacists had the required training to offer smoking cessation services were more willing to provide these services. Qualitative findings also revealed that majority felt they had a unique role to play in providing tobacco cessation services. Conclusions These pharmacists were willing to provide smoking cessation services within their practice, however they may require specific training to do so effectively. In developing guidelines for community based smoking cessation, it is recommended that pharmacists be engaged and trained for the provision of smoking cessation services within the community