Background: Tobacco smoking causes over 8 million deaths annually worldwide and is expected to increase by 148% in sub-Saharan Africa by 2030. This puts significant strain on already heavily burdened healthcare systems. Healthcare workers (HCWs) are at the forefront of patient care and play a crucial role in smoking cessation (SC) efforts. Objectives: To assesses the effectiveness and identify barriers to smoking cessation provision by HCWs in sub-Saharan Africa. Method: A systematic review was conducted in accordance with PRISMA guidelines to retrieve studies relevant to the implementation of SC strategies in sub-Saharan Africa and research on the barriers and facilitators of the adoption of SC practices. Studies were retrieved from PubMed, Medline, Ovid, Cochrane Library and Scopus; all included literature was published in English after 2014. Risk of bias and methodological quality were evaluated through the Critical Appraisal Skills Programme (CASP) tool. Results: Twelve studies met the inclusion criteria. HCWs in sub-Saharan with formal training were more likely to offer SC interventions, with lack of training and resources identified as key barriers. Greater HCW engagement with patients also facilitated SC efforts. Inadequate resources, cultural differences and structural failures were further barriers. Socioeconomic and educational differences also influenced quit attempts, with wealthier and better-educated individuals more likely to quit. Discussion: HCW competency and training significantly impacts SC efforts, suggesting the need for comprehensive programs to boost HCW skills and knowledge. Socioeconomic and cultural factors also affected SC outcomes, highlighting the need for tailored health campaigns. However, the heterogenicity of the evidence base makes it challenging to compare SC interventions and determine if identified barriers are only region specific or generalisable. Conclusion: HCW training and support is crucial for SC provision across sub-Saharan Africa, but structural barriers and sociocultural challenges must be addressed for these programs to succeed. Interventions should therefore both empower HCWs and be tailored to the local area.

The authors have declared no competing interest.

https://osf.io/6wf25/?view_only=6e1348facda14ac68e36a0c34bebe8b9

This study did not receive any funding

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