In e na ional Jou nal o Clinical Science and Medical Resea ch
ISSN(p in ): 2770-5803, ISSN(online): 2770-582X
Volume 05 Issue 10 Oc obe 2025
DOI: h ps://doi.o g/10.55677/IJCSMR/V5I10-04/2025, Impac Fac o : 8.005
Page No : 237-243
237 A ailable a : h ps://jou nalo medical.o g/
Assessing he Impac o Smoking Cessa ion T aining o Heal hca e
P o ide s: A P e-Pos In e en ion S udy by he Bun ong Heal h Clinic Qui
Smoking Clinic Team
Su end an Viliam1, Subashini Ambigapa hy1, Muhammad Nuh Idy Razlan2,
1Klinik Kesiha an Bun ong, Ipoh, Pe ak
2Clinical Resea ch Cen e, Hospi al Raja Pe maisu i Bainun (HRPB), Ipoh, Pe ak
ABSTRACT Published Online: Oc obe 08, 2025
Pu pose: Smoking cessa ion emains a c i ical public heal h challenge, equi ing e ec i e in e en ions
led by ained heal hca e p o ide s. This s udy e alua es he impac o a s uc u ed smoking cessa ion
aining p og am on heal hca e p o ide s’ knowledge, a i udes, and sel -e icacy in smoking cessa ion
counselling.
Me hods: A p e-pos in e en ion s udy was conduc ed among 159 heal hca e p o ide s, including
doc o s, pha macis s, medical assis an s, and nu ses, who a ended a s uc u ed smoking cessa ion
aining p og am a Klinik Kesiha an Bun ong, Malaysia. The aining comp ised lec u es, hands-on
p ac ical sessions, and ole-playing exe cises ocused on e idence-based smoking cessa ion s a egies.
The P o ide s’ Smoking Cessa ion T aining E alua ion (P oSCiTE) ool was used o assess
pa icipan s’ knowledge, a i udes, and sel -e icacy be o e and a e aining. Pai ed - es s and
McNema ’s es s we e conduc ed o analyse he changes.
Resul s: Signi ican imp o emen s we e obse ed ac oss all h ee measu ed domains. The mean
knowledge sco e inc eased by 2.8 poin s (p < 0.001), a i ude sco es imp o ed by 1.4 poin s (p < 0.001),
and sel -e icacy sco es ose by 8.9 poin s (p < 0.001). Medical assis an s demons a ed he highes
knowledge imp o emen , while pha macis s exhibi ed he g ea es inc ease in sel -e icacy. Despi e
o e all posi i e ou comes, a i ude imp o emen s among pha macis s and nu ses we e no s a is ically
signi ican . Addi ionally, he aining led o a signi ican ise in pa icipan s' in e es in u he skill
enhancemen in smoking cessa ion counselling (p < 0.001).
Conclusion: The s uc u ed aining p og am signi ican ly enhanced heal hca e p o ide s’
compe encies in smoking cessa ion counselling, ein o cing he impo ance o a ge ed educa ional
in e en ions. The indings unde sco e he need o p o ession-speci ic s a egies o add ess a i ude-
ela ed ba ie s and sus ain long- e m impac . Fu u e aining ini ia i es should inco po a e digi al
ools, ein o cemen aining, and con inuous p o essional de elopmen o op imize smoking cessa ion
e o s and imp o e public heal h ou comes in Malaysia.
KEYWORDS:
Malaysia, P oSCiTE,
smoking cessa ion,
WHO FTFC,
MPOWER
1. INTRODUCTION
Nico ine addic ion emains a c i ical global heal h challenge,
wi h smoking con ibu ing o a wide ange o diseases,
including cance , hea disease, s oke, and lung diso de s, as
highligh ed by he Uni ed S a es' Cen e s o Disease Con ol
Co esponding Au ho : Su end an Viliam
*Ci e his A icle: Su end an Viliam, Subashini Ambigapa hy,
Muhammad Nuh Idy Razlan (2025). Assessing he Impac o
Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-
Pos In e en ion S udy by he Bun ong Heal h Clinic Qui
Smoking Clinic Team. In e na ional Jou nal o Clinical
Science and Medical Resea ch, 5(10), 237-243
and P e en ion (CDC).[1] This addic ion is esponsible o
o e 8 million dea hs wo ldwide annually, wi h he Wo ld
Heal h O ganiza ion (WHO) epo ing ha obacco use is
a al o up o hal o i s consume s.[2]
Each yea , o e 7 million dea hs a e di ec ly caused by
obacco use, wi h an addi ional 1.2 million a ibu ed o
secondhand smoke exposu e. Wi h no sa e le el o exposu e,
secondhand smoke poses a pe asi e and le hal h ea o bo h
smoke s and non-smoke s alike.[2]
Su end an Viliam e al, Assessing he Impac o Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-Pos
In e en ion S udy by he Bun ong Heal h Clinic Qui Smoking Clinic Team
238 A ailable a : h ps://jou nalo medical.o g/
In Malaysia, smoking emains a signi ican public heal h
conce n despi e a modes decline in p e alence. The smoking
a e among indi iduals aged 15 and olde d opped om
22.8% in 2015 o 21.3% in 2019, as epo ed in Malaysia’s
2020 submission o he WHO F amewo k Con en ion on
Tobacco Con ol (WHO FCTC).[3] Howe e , he 2019
Na ional Heal h and Mo bidi y Su ey (NHMS) es ima ed
ha 4.9 million Malaysians aged 15 and olde con inue o
smoke.[4]
The WHO FCTC, es ablished in 2005, is a landma k global
ea y aimed a comba ing he obacco epidemic. By 2016,
180 coun ies had a i ied he ea y, commi ing o educing
he supply and demand o obacco p oduc s.[5]To suppo i s
implemen a ion, WHO in oduced he MPOWER package in
2008, which ou lines six key s a egies: moni o ing obacco
use, p o ec ing indi iduals om obacco smoke, o e ing help
o qui , wa ning abou he dange s o obacco, en o cing
ad e ising bans, and aising obacco axes — summa ized as
Moni o , P o ec , O e , Wa n, En o ce, and Raise Tax.[5,6]
In line wi h he WHO FCTC, he Malaysian Minis y o
Heal h launched he Na ional S a egic Plan on Tobacco
Con ol in 2015, adop ing he MPOWER s a egy. A c i ical
ocus is ‘O’ - O e ing help o qui obacco use, which
emphasizes he ole o heal hca e p o ide s in cessa ion
e o s. E idence shows ha aining heal hca e p o ide s
signi ican ly enhances hei abili y o suppo pa ien s in
qui ing, wi h e en b ie in e en ions inc easing he
likelihood o qui a emp s. [7,8,9] Despi e his, o e 50% o
p ima y ca e p o ide s in Malaysia do no ou inely
implemen hese in e en ions due o inadequa e knowledge
and skills.[9]
Malaysia has made mixed p og ess wi h he MPOWER
s a egy. A comple e measu e o 'M - Moni o ing' was
achie ed in 2016, while 'P - P o ec ' emains
unde de eloped.[6] The coun y excelled in 'W - Wa n' wi h
packaging wa nings (2017) and mass media campaigns
(2018) aising obacco isk awa eness.[6] Mode a e measu es
ha e been achie ed o 'E - En o ce' and 'R - Raise Tax,' wi h
a ax a e o 51.6%.[6]
E o s in 'O - O e ing help o qui obacco use' emain
mode a e.[6] S eng hening his a ea could subs an ially
educe smoking p e alence and associa ed heal h bu dens.
Smoking poses signi ican challenges in Malaysia, wi h o e
27,200 smoking- ela ed dea hs annually and an es ima ed
RM3 billion spen yea ly on ea ing majo smoking- ela ed
diseases. [3,4]
Heal hca e p o ide s a e pi o al in add essing his issue
h ough e ec i e obacco cessa ion suppo . S eng hening
he 'O' componen o MPOWER by equipping p o ide s wi h
obus cessa ion s a egies is c i ical o educing smoking-
ela ed illnesses and alle ia ing he subs an ial inancial s ain
on he heal hca e sys em.
This s udy assesses he Qui Smoking Team’s aining
p og am a Bun ong Heal h Clinic, aimed a enhancing
heal hca e p o essionals' smoking cessa ion skills. Using he
P o ide s' Smoking Cessa ion T aining E alua ion
(P oSCiTE) ool, i e alua es knowledge, a i udes, and sel -
e icacy sco es p e- and pos - aining ac oss p o essional
g oups, p o iding insigh s o imp o e compe ence and
con idence in cessa ion in e en ions.[10]
II. METHODOLOGY
This s udy was a c oss-sec ional p e-pos in e en ion
analysis aimed a e alua ing he e ec i eness o a aining
p og am p o ided by he Bun ong Heal h Clinic Qui
Smoking Team. The s udy included doc o s, pha macis s,
medical assis an s, and nu ses who a ended he aining.
Ini ially, pa icipan s comple ed a ques ionnai e co e ing
demog aphic da a, knowledge, a i udes owa ds smoking
cessa ion, and sel -e icacy ela ed o smoking cessa ion
in e en ions be o e he aining.
The aining consis ed o a 5-hou session wi h lec u es on
obacco, non-pha macological and pha macological
app oaches, and mo i a ional in e iewing, ollowed by a 3-
hou p ac ical session wi h hands-on aining and ole-playing
exe cises. Pa icipan s hen comple ed he same ques ionnai e
a e he aining. Da a we e collec ed wi hou pe sonal
iden i ie s om he cou se o ganize s.
The s udy popula ion comp ised heal hca e p o ide s om
go e nmen heal h clinics ac oss Pe ak who a ended he Qui
Smoking Clinic T aining on Sep embe 19, 2023. Pa icipan s
we e included ega dless o p io expe ience in qui smoking
clinics. The s udy si e was Klinik Kesiha an Bun ong, whe e
he aining was o ganized.
All 159 heal hca e p o ide s who a ended he aining we e
included in he s udy, wi h no addi ional sample size
calcula ions o sampling me hods used. Inclusion c i e ia
we e doc o s, pha macis s, nu ses, and medical assis an s
om go e nmen heal h clinics in Pe ak who pa icipa ed in
he aining. Exclusion c i e ia included pa icipan s who did
no comple e any ques ionnai es o who answe ed only one
se o ques ionnai es.
III. INSTRUMENT
Pe mission was ob ained om he au ho s o he P oSCiTE
ques ionnai e, Si i Idayu Hasan, e . al., o use in his s udy.
The alida ed P oSCiTE ques ionnai e, de eloped in 2019,
includes six sec ions: demog aphic backg ound, knowledge
(12 i ems), a i ude (8 i ems), sel -e icacy (13 i ems),
beha iou (19 i ems), and ba ie s (15 i ems). Fo his s udy,
he ocus was na owed o h ee key componen s—
knowledge, a i ude, and sel -e icacy— o assess he
immedia e impac o he aining.
Su end an Viliam e al, Assessing he Impac o Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-Pos
In e en ion S udy by he Bun ong Heal h Clinic Qui Smoking Clinic Team
239 A ailable a : h ps://jou nalo medical.o g/
Table I: Heal hca e P o ide s’ Cha ac e is ics. (N = 159)
Va iables
All ainees
Doc o s
Pha macis s
MAs
Nu ses
To al ainees, n (%)
159 (100)
57 (35.8)
32 (20.1)
58 (36.5)
12 (7.5)
Age in yea s, n (%)
20-29
47 (29.6)
9 (15.8)
6 (18.8)
23 (39.7)
9 (75.0)
30-39
90 (56.6)
38 (66.7)
24 (75.0)
26 (44.8)
2 (16.7)
40-49
19 (11.9)
10 (17.5)
2 (6.3)
6 (10.3)
1 (8.3)
≥50
3 (1.9)
0 (0.0)
0 (0.0)
3 (5.2)
0 (0.0)
Age (yea s), median (IQR)
33.0 (30.0,
37.0)
34.0 (31.0,
38.0)
31.5(30.0,
36.0)
30.0 (28.0,
36.0)
37.5 (33.0,
40.0)
Wo k expe ience (yea s), n (%)
<5
60 (37.7)
24 (42.1)
7 (21.9)
29 (50.0)
0 (0.0)
5-9
50 (31.4)
17 (29.8)
16 (50.0)
15 (25.9)
2 (16.7)
10-14
30 (18.9)
11 (19.3)
7 (21.9)
6 (10.3)
6 (50.0)
≥15
19 (11.9)
5 (8.8)
2 (6.3)
8 (13.8)
4 (33.3)
Wo king expe ience (yea s),
mean (SD)
8.1 (5.67)
7.3 (4.72)
8.2 (4.28)
7.5 (6.59)
14.1 (5.33)
Gende , n (%)
Male
80 (50.3)
18 (31.6)
9 (28.1)
53 (91.4)
0 (0.0)
Female
79 (49.7)
39 (68.4)
23 (71.9)
5 (8.6)
12 (100.0)
Highes quali ica ion, n (%)
Diploma
60 (37.7)
0 (0.0)
0 (0.0)
52 (89.7)
8 (66.7)
Deg ee
87 (54.7)
49 (86.0)
32 (100.0)
6 (10.3)
0 (0.0)
Mas e
7 (4.4)
7 (12.3)
0 (0.0)
0 (0.0)
0 (0.0)
PHD
0 (0.0)
0 (0.0)
0 (0.0)
0 (0.0)
0 (0.0)
O he s
5 (3.1)
1 (1.8)
0 (0.0)
0 (0.0)
4 (33.3)
Tobacco-use s a us, n (%)
Cu en smoke
30 (18.9)
6 (10.5)
4 (12.5)
15 (25.9)
5 (41.7)
Fo me smoke
11 (6.9)
2 (3.5)
2 (6.3)
7 (12.1)
0 (0.0)
Non-smoke
118 (74.2)
49 (86.0)
26 (81.3)
36 (62.1)
7 (58.3)
Pe cen age ange o smoke s in pa ien s, n (%)
0-25%
53 (33.3)
20 (35.1)
8 (25.0)
18 (31.0)
7 (58.3)
26%-50%
53 (33.3)
24 (42.1)
4 (12.5)
23 (39.7)
2 (16.7)
51%-75%
16 (10.1)
8 (14.0)
2 (6.3)
4 (6.9)
2 (16.7)
76%-100%
6 (3.8)
2 (3.5)
1 (3.1)
3 (5.2)
0 (0.0)
Unsu e
31 (19.5)
3 (5.3)
17 (53.1)
10 (17.2)
1 (8.3)
A ailabili y o Qui Smoking Clinic, n (%)
Yes
148 (93.1)
57 (100.0)
27 (84.4)
55 (94.8)
9 (75.0)
No
10 (6.3)
0 (0.0)
4 (12.5)
3 (5.2)
3 (25.0)
Unsu e
1 (0.6)
0 (0.0)
1 (3.1)
0 (0.0)
0 (0.0)
A ended Qui Smoking cou ses be o e, n (%)
Yes
78 (49.1)
31 (54.4)
19 (59.4)
25 (43.1)
3 (25.0)
No
81 (50.9)
26 (45.6)
13 (40.6)
33 (56.9)
9 (75.0)
In e es in upg ading smoking cessa ion counselling skill, p e-cou se, n (%)
No a all in e es ed
3 (1.9)
0 (0.0)
1 (3.1)
1 (1.7)
1 (8.3)
Sligh ly in e es ed
9 (5.7)
1 (1.8)
0 (0.0)
5 (8.6)
3 (25.0)
Mode a e in e es ed
73 (45.9)
18 (31.6)
15 (46.9)
35 (60.3)
5 (41.7)
Ex emely in e es ed
74 (46.5)
38 (66.7)
16 (50.0)
17 (29.3)
3 (25.0)
In e es in upg ading smoking cessa ion counselling skill, pos -cou se, n (%)
No a all in e es ed
1 (0.6)
0 (0.0)
0 (0.0)
0 (0.0)
1 (8.3)
Sligh ly in e es ed
6 (3.8)
1 (1.8)
2 (6.3)
3 (5.2)
0 (0.0)
Mode a e in e es ed
56 (35.2)
17 (29.8)
9 (28.1)
26 (44.8)
4 (33.3)
Ex emely in e es ed
96 (60.4)
39 (68.4)
21 (65.6)
29 (50.0)
7 (58.3)
Su end an Viliam e al, Assessing he Impac o Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-Pos
In e en ion S udy by he Bun ong Heal h Clinic Qui Smoking Clinic Team
240 A ailable a : h ps://jou nalo medical.o g/
The e ised ques ionnai e consis s o ou sec ions. Sec ion A
ga he s demog aphic in o ma ion such as age, gende ,
educa ion le el, wo k expe ience, smoking s a us, and
p o ession ype. The ‘pe cen age ange o smoke s’ pa ien s’
indica ed how many pa ien s seen by he pa icipan in a
ypical week a e smoke s, wi h ca ego ies anging om 0-
25% o 76-100% and an op ion o Unsu e. Thei in e es in
upg ading smoking cessa ion counselling skills on a scale o
1 o 5, om No a All In e es ed o Ex emely In e es ed.
Sec ion B e alua es knowledge o smoking cessa ion
wi hd awal symp oms. Knowledge sco e was assessed
h ough 12 ques ions wi h bina y answe s (Yes/No), anging
om 0 o 12 wi h 12 ques ions, sco ed ou o 12.
Sec ion C and D assess a i udes and sel -e icacy owa d
smoking cessa ion in e en ions using 5-poin Like scales
(1 = s ongly ag ee, 5 = s ongly disag ee). A i ude is
measu ed wi h 8 ques ions (max sco e = 40), while sel -
e icacy is e alua ed wi h 13 ques ions (max sco e = 65).
IV. RESULTS
A o al o 159 heal hca e p o ide s pa icipa ed in he aining
p og am, comp ising doc o s (n = 57, 35.8%), pha macis s (n
= 32, 20.1%), medical assis an s (n = 58, 36.5%), and nu ses
(n = 12, 7.5%). The mean age o pa icipan s was 33.8 yea s
(SD = 6.16), wi h he majo i y alling wi hin he 30-39 age
g oup (n = 97, 61%). The mean du a ion o p o essional
expe ience was 8.1 yea s (SD = 5.67), wi h 37.7% (n = 60)
ha ing less han i e yea s o expe ience. Mos pa icipan s
we e non-smoke s (n = 118, 74.2%), while 30 pa icipan s
(18.9%) we e cu en smoke s, and 11 (6.9%) we e o me
smoke s.
The majo i y o pa icipan s (n = 148, 93.1%) we e om
clinics o e ing Qui Smoking Clinic se ices, and
app oxima ely hal (n = 78, 49.1%) had a ended p e ious
smoking cessa ion aining. P io o he cou se, 45.9% (n =
73) o pa icipan s epo ed mode a e in e es in imp o ing
hei smoking cessa ion counselling skills, while 46.5% (n =
74) exp essed ex eme in e es .
Pos - aining, he p opo ion o pa icipan s wi h ex eme
in e es inc eased o 60.4% (n = 96), e lec ing an o e all
posi i e shi in mo i a ion. A McNema ’s es was conduc ed
o assess changes in in e es le els be o e and a e he
in e en ion. The esul s showed a signi ican shi in in e es ,
χ² (1, N = 159) = 13.781, p < 0.001, indica ing ha mo e
pa icipan s became ex emely in e es ed pos -in e en ion.
Table II. Resul s o McNema ’s Tes o Changes in
In e es Le els Be o e and A e he In e en ion
P e-In e en ion In e es
Pos -In e en ion In e es
n
Mode a ely, sligh ly, and
no in e es ed
Mode a ely, sligh ly, and
no in e es ed
58
Mode a ely, sligh ly, and
no in e es ed
Ex emely in e es ed
27
Ex emely in e es ed
Mode a ely, sligh ly, and
no in e es ed
5
Ex emely in e es ed
Ex emely in e es ed
69
A pai ed sample - es was conduc ed o e alua e he impac
o he aining on pa icipan s' knowledge, a i udes, and sel -
e icacy. S a is ically signi ican imp o emen s we e
obse ed in all h ee domains (p < .001). The mean
knowledge sco e inc eased by 2.8 poin s (95% CI = 2.41,
3.27), he mean a i ude sco e imp o ed by 1.4 poin s (95%
CI = 0.85, 1.97), and he mean sel -e icacy sco e inc eased
by 8.9 poin s (95% CI = 7.82, 10.05).
Fig. 1: Mean sco es o Knowledge, A i ude and Sel -
e icacy p e- and pos - aining (p<.001).
When analysed by p o ession, medical assis an s exhibi ed
he highes imp o emen in knowledge sco es, wi h an
inc ease o 3.3 poin s (95% CI = 2.43, 4.16, p < .001).
Pha macis s demons a ed he highes imp o emen in sel -
e icacy, wi h an inc ease o 10.2 poin s (95% CI = 7.63,
12.69, p < .001). A i ude sco es showed signi ican
imp o emen ac oss all p o essions excep o pha macis s
and nu ses, whe e changes we e no s a is ically signi ican (p
= 0.08 and p = .197, espec i ely).
Pos - aining assessmen s e ealed ha pha macis s e ained
he highes mean knowledge sco es (11.5, SD = 0.95), while
doc o s main ained he highes pos - aining mean a i ude
(36.7, SD = 3.78) and sel -e icacy sco es (58.0, SD = 6.17).
Despi e o e all imp o emen s, he ela i ely smalle gains in
a i ude sco es o pha macis s and nu ses sugges he need
o ailo ed in e en ions o enhance pe cep ion and
con idence in smoking cessa ion p ac ices.
8.1
33.9
46.8
10.9
35.3
55.8
0
10
20
30
40
50
60
Knowledge A i ude Sel -e icacy
Mean sco es
P e- aining Pos - aining
Su end an Viliam e al, Assessing he Impac o Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-Pos
In e en ion S udy by he Bun ong Heal h Clinic Qui Smoking Clinic Team
241 A ailable a : h ps://jou nalo medical.o g/
Table III. Pai ed Sample -Tes Compa ing P e- and Pos -T aining To al Knowledge, A i ude, and Sel -E icacy Sco es
Ac oss P o essions
Va iables
P e- aining,
Mean (SD)
Pos - aining,
Mean (SD)
Mean di e ence
(95% CI)
(d )
p
Sco es o all ainees, (n =159)
Knowledge
8.1 (2.84)
10.9 (2.36)
2.8 (2.41, 3.27)
13.045 (158)
<.001
A i ude
33.9 (4.19)
35.3 (4.14)
1.4 (0.85, 1.97)
4.978 (158)
<.001
Sel -e icacy
46.8 (7.71)
55.8 (6.40)
8.9 (7.82, 10.05)
15.852 (158)
<.001
Sco es o Doc o s, (n = 57)
Knowledge
8.6 (2.74)
11.2 (1.90)
2.6 (1.87, 3.29)
7.304 (56)
<.001
A i ude
35.5 (3.24)
36.7 (3.78)
1.2 (0.59, 1.77)
3.996 (56)
<.001
Sel -e icacy
48.4 (7.69)
58.0 (6.17)
9.5 (7.76, 11.29)
10.798 (56)
<.001
Sco es o Pha macis s, (n = 32)
Knowledge
8.7 (1.63)
11.5 (0.95)
2.8 (2.07, 3.43)
8.258 (31)
<.001
A i ude
34.4 (3.71)
35.2 (3.61)
0.7 (-0.09, 1.53)
1.810 (31)
.08
Sel -e icacy
43.6 (7.30)
53.8 (5.27)
10.2 (7.63, 12.69)
8.183 (31)
<.001
Sco es o Medical Assis an s, (n = 58)
Knowledge
7.2 (3.20)
10.5 (2.92)
3.3 (2.43, 4.16)
7.617 (57)
<.001
A i ude
32.3 (4.23)
34.2 (4.45)
1.9 (0.67, 3.16)
3.068 (57)
.003
Sel -e icacy
47.0 (6.61)
55.1 (6.26)
8.0 (6.14, 9.90)
8.550 (57)
<.001
Sco es o Nu ses, (n = 12)
Knowledge
8.1 (3.20)
10.3 (3.49)
2.2 (0.87, 3.46)
3.684 (11)
.004
A i ude
32.7 (6.11)
34.6 (4.06)
1.9 (-1.15, 4.99)
1.374 (11)
.197
Sel -e icacy
46.9 (11.53)
54.3 (8.38)
7.3 (1.53, 13.14)
2.780 (11)
.018
The aining signi ican ly imp o ed knowledge, a i udes, and
sel -e icacy among heal hca e p o ide s. Medical assis an s
demons a ed he highes inc ease in knowledge sco es, while
pha macis s showed he g ea es imp o emen in sel -
e icacy. A i ude imp o emen s we e signi ican o mos
g oups, excep o pha macis s and nu ses. Pos - aining,
pha macis s e ained he highes knowledge sco es, while
doc o s exhibi ed he highes a i ude and sel -e icacy le els.
The inc ease in pa icipan s' in e es in smoking cessa ion
counseling pos - aining highligh s he p og am's
e ec i eness in os e ing mo i a ion and skill enhancemen
These esul s unde sco e he impo ance o s uc u ed aining
p og ams in equipping heal hca e p o ide s wi h he
necessa y compe encies o suppo smoking cessa ion e o s
e ec i ely. Fu u e aining should inco po a e a ge ed
s a egies o add ess a i ude- ela ed ba ie s among
pha macis s and nu ses.
V. DISCUSSION
The indings o his s udy demons a e ha he aining
p og am conduc ed by he Bun ong Heal h Clinic Qui
Smoking Team signi ican ly imp o ed he knowledge,
a i udes, and sel -e icacy o heal hca e p o ide s in smoking
cessa ion in e en ions. These esul s align wi h exis ing
li e a u e sugges ing ha s uc u ed aining enhances he
compe ency and con idence o heal hca e p o essionals in
deli e ing smoking cessa ion suppo .[7]
The signi ican inc ease in knowledge sco es among
pa icipan s, pa icula ly among medical assis an s, indica es
ha he aining e ec i ely p o ided essen ial in o ma ion on
smoking cessa ion s a egies. This inding is consis en wi h
a s udy by Hasan e al. (2019), which epo ed ha an 8-hou
Smoking Cessa ion O ganising, Planning and Execu ion
(SCOPE) aining p og am in Malaysia led o a signi ican
inc ease in knowledge sco es among heal hca e p o ide s.[10]
Simila ly, K is ina e al. (2015) ound ha a one-day
wo kshop o Indonesian communi y pha macis s
signi ican ly imp o ed hei knowledge, pe cei ed ole, and
sel -e icacy in smoking cessa ion counselling.[11]
While o e all a i ude sco es imp o ed signi ican ly, he
changes we e no s a is ically signi ican among pha macis s
and nu ses. This sugges s ha while he aining had a
posi i e in luence, addi ional a ge ed in e en ions may be
necessa y o add ess speci ic conce ns o ba ie s wi hin hese
p o essional g oups. Fac o s such as p io exposu e o
cessa ion aining o di e ing p o essional oles in smoking
cessa ion counselling may explain hese a ia ions.[7]
Findings om ano he s udy conduc ed in Malaysia
emphasized he impo ance o ailo ed in e en ions o
Su end an Viliam e al, Assessing he Impac o Smoking Cessa ion T aining o Heal hca e P o ide s: A P e-Pos
In e en ion S udy by he Bun ong Heal h Clinic Qui Smoking Clinic Team
242 A ailable a : h ps://jou nalo medical.o g/
di e en heal hca e oles o op imize aining
e ec i eness.[12] Addi ionally, Me sha e al. (2023)
highligh ed ha heal hca e p o ide s' a i udes owa d
smoking cessa ion in e en ions play a c ucial ole in
imp o ing adhe ence o cessa ion s a egies, sugges ing ha
in e en ions should include ein o cemen aining o sus ain
posi i e a i udes o e ime.[14]
Sel -e icacy showed he highes inc ease, pa icula ly among
pha macis s. This is a c ucial inding, as highe sel -e icacy
is associa ed wi h a g ea e likelihood o ac i ely engaging in
pa ien counselling and in e en ion e o s. The s uc u ed
ole-playing and p ac ical exe cises included in he aining
may ha e con ibu ed o his imp o emen , ein o cing
con idence in deli e ing smoking cessa ion suppo .[13]
Simila ly, a s udy by P eechawong e al. (2011) ound ha a
heo y-based aining p og am in obacco cessa ion
counselling signi ican ly inc eased nu ses' con idence and
p o ision o counselling.[13] Howe e , ba ie s such as ime
cons ain s, lack o ins i u ional suppo , and limi ed access o
pha maco he apy ha e been no ed in p io s udies as
challenges ha educe he e ec i eness o smoking cessa ion
in e en ions.[14] These challenges should be conside ed in
u u e aining p og ams o ensu e sus ained imp o emen s in
p ac ice.
The impo ance o pha maco he apy in smoking cessa ion
was also highligh ed by Me sha e al. (2023), who
emphasized ha heal hca e p o ide s' knowledge and
a i udes owa ds smoking cessa ion medica ion signi ican ly
impac pa ien adhe ence.[14] Ensu ing ha aining includes
comp ehensi e pha maco he apy modules may u he
enhance in e en ion ou comes.
Fu he mo e, a s udy by Li e al. (2021) sugges ed ha
in eg a ing digi al ools and elemedicine in smoking
cessa ion in e en ions could enhance p o ide engagemen
and pa ien adhe ence, poin ing o po en ial ad ancemen s in
cessa ion aining p og ammes.[15].
VI. LIMITATIONS AND FUTURE DIRECTIONS
While he s udy p o ides aluable insigh s, ce ain limi a ions
mus be acknowledged. The absence o a con ol g oup limi s
he abili y o a ibu e imp o emen s solely o he aining
p og am. Addi ionally, he s udy elied on sel - epo ed da a,
which may be subjec o esponse bias. Fu u e esea ch
should conside longi udinal ollow-ups o assess he
e en ion o knowledge and sus ained impac on clinical
p ac ice. Me sha e al. (2023) emphasize ha la ge s udies
ac oss b oade heal hca e p o ide g oups a e needed o
comp ehensi ely assess he e ec i eness o adhe ence
suppo s a egies in smoking cessa ion in e en ions.[14]
To enhance aining ou comes, u u e p og ams should
conside inco po a ing ongoing men o ship, e eshe
cou ses, and digi al lea ning ools o ein o ce key concep s.
Add essing he speci ic needs o di e en heal hca e
p o essions and p o iding con inuous suppo can u he
s eng hen smoking cessa ion in e en ions in Malaysia.
VII. CONCLUSION
O e all, his s udy unde sco es he e ec i eness o s uc u ed
aining p og ams in equipping heal hca e p o ide s wi h
essen ial compe encies o smoking cessa ion in e en ions.
The signi ican imp o emen s in knowledge and sel -e icacy
highligh he alue o such aining in s eng hening he 'O'
componen o MPOWER. Howe e , a ia ions ac oss
p o essional g oups indica e he need o ailo ed s a egies o
add ess speci ic ba ie s and sus ain long- e m impac . Fu u e
ini ia i es should in eg a e p o ession-speci ic aining,
con inuous p o essional de elopmen , and echnology-based
in e en ions o op imize smoking cessa ion e o s and
imp o e public heal h ou comes in Malaysia.
VIII. ACKNOWLEDGMENTS
We ex end ou since e g a i ude o he P ime Uni o Jaba an
Kesiha an Nege i Pe ak o hei in aluable suppo in
p o iding he necessa y da a o his s udy. Ou app ecia ion
also goes o he Qui Smoking Clinic o Bun ong Heal h
Clinic, o hei dedica ion o smoking cessa ion se ices and
hei collabo a ion in his esea ch. We a e especially g a e ul
o he Clinical Resea ch Cen e (CRC), Hospi al Raja
Pe maisu i Bainun (HRPB), o hei expe guidance and
con inuous suppo . Finally, we acknowledge all heal hca e
p o essionals who pa icipa ed in his s udy o hei aluable
con ibu ions, which we e ins umen al in i s success ul
comple ion.
IX. DISCLOSURE
The au ho epo s no con lic s o in e es in his wo k.
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