PhD Thesis Uncovers Barriers to Smoking Cessation Among Drug Resistant TB Patients
UKZN staff member Dr Zifikile Phindile Shangase received a PhD in Public Health for her study on the knowledge, attitudes and beliefs of drug resistant tuberculosis (DR-TB) patients with regard to smoking; the barriers to cessation among current smokers with DR-TB and hospital staff’s knowledge, attitudes, beliefs, and practices with regard to smoking.
She received funding from UKZN’s School of Health Sciences, School of Built Environment and Development Studies and from the National Research Foundation that funded her sabbatical leave to conduct her research.
The study found that addiction-related barriers include smoking history, craving a cigarette, smoking as part of a daily routine, and failed attempts to quit. Non-addiction-related barriers include a lack of knowledge of quitting strategies, psychosocial stress, lack of willpower and peer influence.
Structural barriers include ineffective health education programmes, a lack of extramural activities while in hospital leading to excess spare time, lack of smoking cessation interventions and access to cigarettes within and around the hospital environment. ‘Patients expressed interest in smoking cessation and conveyed their frustration at the lack of appropriate support to do so,’ said Shangase.
The study also proposes a culturally relevant smoking cessation intervention model for DR-TB patients. It involves supportive environments, the adoption of effective public health policies, reorienting health services, developing personal skills and strengthening community action. Shangase hopes that the model will assist hospital staff to effectively address the issues confronting DR-TB patients.
‘There is a need for smoking cessation intervention to be incorporated as an integral component of DR-TB management in South Africa,’ said Shangase. ‘Many patients expressed an interest in Nicotine Replacement Therapy and psychological support to help them to quit smoking. Additionally, offering extramural activities and enforcing smoke-free policies in hospital facilities will help to reduce patients’ access to cigarettes.’
Some of the challenges that Shangase experienced were recruiting DR-TB patients and arranging suitable times for data collection with hospital staff. ‘Together with my research assistants, we also had to be vigilant of infection control measures at all times,’ she added.
Shangase thanked her family, friends and the power of prayer for support.
Offering advice to other researchers, she said, ‘Stay focused and enhance time management skills. Interacting and networking with established researchers who are involved in your field of study is a must.’
Words: Melissa Mungroo
Photograph: Abhi Indrarajan