Intern Emerg Med. 2025 Nov 1. doi: 10.1007/s11739-025-04161-5. Online ahead of print.
ABSTRACT
People with mental health issues (MHI) are disproportionately dependent on tobacco smoking and experience higher rates of smoking-related mortality compared to the general population. Mental health workers (MHWs) are well placed to address this burden, yet many lack the knowledge, confidence, or skills to support smoking cessation or tobacco harm reduction (THR). This study aimed to evaluate the impact of a structured THR training session on the knowledge and attitudes of mental health workers in Malawi. A quasi-experimental pre-post study was conducted among 48 mental health professionals at two psychiatric hospitals in Malawi. Participants attended a structured training session on tobacco harm reduction. Baseline and end-line surveys assessed demographics, prior tobacco harm reduction exposure, knowledge, and attitudes. Knowledge scores were analysed using the Wilcoxon signed-rank test, with descriptive statistics summarising categorical shifts and attitudinal changes. Only 25% of the participants had received prior training on tobacco harm reduction. A statistically significant increase in median knowledge scores from baseline (median = 6, interquartile range [IQR] = 5-7) to end line (median = 8, IQR = 7-9), Z = -5.72, p < 0.001, with a large effect size (r = 0.62) was observed. The proportion of participants classified as having ‘Good’ knowledge increased substantially from 21.3% at baseline to 68.1% at end line, while the ‘Poor’ knowledge category decreasing from 6.4 to 0%. A brief, well-structured training on tobacco harm reduction can help improve knowledge among mental health workers. Scaling up such training could help close a major gap in patient care for people with mental illness in Malawi and similar settings.
PMID:41176585 | DOI:10.1007/s11739-025-04161-5
