Date of Award


Document Type


Degree Name

Master of Medicine (MMed)


Family Medicine (East Africa)


Background: Tobacco use is the leading cause of preventable morbidity and mortality globally. The international community recognizes this epidemic and compelling evidence exists on the significant contribution of the health care provider in propagating the success of tobacco cessation. The World Health Organization highlights minimal implementation of tobacco control policies by Tanzania despite a rise in tobacco use prevalence. Medical doctors’ competence is a reflection on our commitment to tobacco cessation service delivery.

Main Objectives: To assess whether medical doctors have the knowledge that would enable them to competently deliver tobacco cessation services.

Specific Objectives

1. To assess medical doctors’ core knowledge on tobacco use and it`s harmful effects.

2. To assess medical doctors’ knowledge on tobacco screening.

3. To determine medical doctors’ awareness on brief tobacco cessation advice.

Design: Facility based cross-sectional study.

Setting: Public and private health facilities in Dar es Salaam, Tanzania.

Participants: Medical doctors in active clinical practice

Site: Multicenter study from October 2013 to January 2014.

Sample size: 320 medical doctors.

Measurement: A 48 item validated questionnaire was used to assess whether medical doctors have the knowledge that would enable them to competently deliver tobacco cessation services; 35 items were scored and each item scored 1 point, two items were nullified because nicotine replacement therapy has not yet been legalized, while 11 items explored participant’s recommendation on tobacco. Competence was defined as an overall score above 25 (71%) of the 35 items.

Results: 320 questionnaires were analyzed. Only 21 doctors (7%) attained acceptable level of competence; which was insignificant p=0.4 (significant p< 0.05) and 62 doctors (19%) reflected satisfactorily on tobacco cessation services.

Conclusion: The level of acceptable knowledge for competent delivery of tobacco cessation services was low. Doctors affirm that they need further training. Enforcing sustainable ways of integrating comprehensive and evidence based tobacco education and cessation services in our local health care systems are recommended to improve competence in tobacco cessation service delivery.