Effect of a Program to Enhance Health Literacy and Self-Efficacy in Assisting Smoking Cessation among Village Health Volunteers in Samut Songkhram Province, Thailand

Abstract

Smoking is a risk factor to health and an important cause of disease and premature death, especially among adolescents and patients with non-communicable diseases. It is an important public health problem in countries around the world, including Thailand. Cigarettes contain about 600 ingredients. When the ingredients burn, they generate more than 7,000 chemicals, 25 of which are harmful to health and at least 70 of them are linked to cancer. Smoking can lead to a variety of ongoing complications in the body. Tobacco smoke is incredibly harmful to health, while smoking can increase the risk of a variety of problems over several years. Some of the bodily effects are immediate, such as mood stimulation, anxiety and irritability, smelly hair, unhealthy teeth, yellow fingers, bronchitis, poor vision, dull sense of smell and taste, persistent coughing, and loss of appetite. Others have a long-term effect, for instance, the nicotine in cigarettes increases heart rate and blood pressure, carbon monoxide inhibits oxygen circulation in the body, and smoking is associated with diseases such as cancer, hypertension and hypertension complications, diabetes mellitus and diabetes complications, dyslipidemia, immune dysfunction, infertility, heart disease, constricted blood vessels, and chronic obstructive pulmonary disease (COPD). At present, smoking is also a risk factor of coronavirus infection (COVID-19).

Village health volunteers (VHVs) are health workers that play important roles, and constitute an important workforce in tobacco control. They facilitate smoking cessation in a community. Promotion of health literacy and self-efficacy among VHVs regarding the harmful effects of tobacco; toxins in tobacco smoke; and techniques, skill training, benefits and media literacy about assisting people to stop smoking, could promote VHVs confidence in assisting with smoking cessation. Therefore, health literacy and self-efficacy of VHVs in assisting people with smoking cessation should be improved to promote successful smoking cessation in the community.  

The purpose of this quasi-experimental research was to examine the effect of a program designed to enhance health literacy and self-efficacy in providing assistance with smoking cessation among VHVs in Samut Songkhram Province, Thailand. The study involved VHVs (n=60), divided into the experimental group and comparison group. Participants in the experimental group received five weekly sessions of the enhancement program on health literacy and self-efficacy in assisting with smoking cessation. The comparison group received educational material about tobacco control. Data were collected using a questionnaire at pretest and posttest, and analyzed by using a paired t-test and independent t-test.

The research findings showed that after the intervention, mean scores in: cognitive skill in assisting with tobacco and smoking cessation; skill in accessing health data; skill in communicating health data; decision-making skills, self-management, and media literacy to assist with smoking cessation; along with self-efficacy and smoking cessation assistance behavior, were significantly higher in the experimental group than in comparison group and significantly higher than at pretest (p <0.05).

The findings of this study suggest that learning and seeing the success of other people can also change behavior to assist with smoking cessation and increase health literacy of VHVs. This program can promote health literacy and self-efficacy in assisting people with smoking cessation among VHVs, and can help smokers to stop smoking.