Objective:
To evaluate the effect of two train-the-trainer programs to equip pharmacists for the support of patients with tobacco-nicotine dependence in Japan.

Methods:
A total of 132 pharmacists participated in either a 2-hour lecture or a half-day program consisting of a 2-hour lecture and 2-hour interactive workshop, conducted in five areas between September 2018 and March 2019. We compared participants’ attitude, self-efficacy, and skills for smoking cessation to determine the effect of two programs.

Results:
The 2-hour lectures were attended by 97 pharmacists, while 15 participated in the half-day program. Data were collected using a pre-post survey, with follow-up rates of 89% and 65%, respectively. Prior to the program, 76% of lecture participants and 67% of the half-day program participants were not board-certified tobacco cessation specialists (p<0.11). For both programs, participants’ self-rated attitude, self-efficacy, and skills related to tobacco cessation significantly increased post-training (all p< 0.05). After controlling for potential baseline confounding by age, gender, workplace, smoking status, and registration as a tobacco cessation specialist, participants’ self-efficacy (range: 12-60 points) showed greater improvement for the half-day program compared to the 2-hour lecture, which showed a mean increase of 3.6 points (confidence interval: 0.1 to 7.2; P = 0.04 for between-group comparison).

Conclusions:
Both programs significantly improved attitude, self-efficacy, and skills for supporting patients with tobacco-nicotine dependence. The program comprising of both the lecture and the workshop facilitated greater improvement in self-efficacy, compared to the lecture only.