Assessing smoking cessation services and pharmacotherapy in Namibia: findings and implications for future policy initiatives

Background: Tobacco smoking is a considerable barrier to reducing morbidity and mortality associated with non-communicable diseases (NCDs). However, few studies in sub-Saharan Africa have explored access to smoking cessation programs including smoking cessation pharmacotherapy (SCP). This needs to be addressed given the growing burden of NCDs across sub-Saharan Africa including Namibia. Methods: Multi-facility cross sectional survey among physicians in both public and private sectors in Namibia. Results: Of the 106 physicians recruited, 69% practiced in public health facilities and 92% were non-smokers. 67% offer smoking cessation services, with 64% of these offering SCP. This was mainly nicotine replacement therapy (53%) and bupropion SR (41%). Overall, all physicians had a low knowledge score of SCP (<50%). The mean knowledge score though was 77% lower among physicians in public versus private sectors (OR=0.23, 95%CI: 0.14-0.35, p<0.001). Principal barriers to prescribing SCP were inadequate knowledge and/or lack of smoking cessation guidelines. This is not surprising with SCP medicines not currently listed within the public medicine list in Namibia. Conclusion: Despite good attitudes towards SCP, there are concerns with physicians’ knowledge and practices especially in the public sector. There is an urgent need to address this and integrate services to reduce NCDs in Namibia.