Introduction:
Pharmacists should offer tobacco cessation programs as a highly accessible healthcare professional. However, comprehensive tobacco cessation training is not generally offered in pharmacy schools and regional pharmaceutical associations in Japan. We tried to evaluate the effect of a train-the-pharmacists program for tobacco-nicotine cessation.

Objectives:
To assess the knowledge and perception of pharmacists in Japan regarding tobacco-nicotine cessation.

Methods:
A total of 311 pharmacists participated in a half-day program consisting of a 2-hour lecture and 1.5-hour interactive workshop. Both before and after the program, participants answered a paper-based questionnaire.

Results:
A total of 266 participants completed the survey (response rate of 86%). Our study showed low awareness among participants concerning tobacco use as a risk factor for non-communicable diseases, i.e., liver cancer, diabetes, and stroke, 29%, 23%, 65%, respectively. After the program, almost participants answered that those diseases had causally linked to tobacco use (86%, 87%, 95%, respectively, all p< 0.001). Although only 13% and 10% of participants responded that heat-not-burn tobacco and e-cigarettes contain nicotine were less harmful than smoked tobacco, 41% of them answered that e-cigarettes without nicotine were less health risk than cigarettes. Participants’ knowledge and perception related to new tobacco products significantly increased post-training.

Conclusion(s):
A train-the-pharmacist program significantly improved the knowledge and perception for supporting patients with tobacco-nicotine cessation. As new findings reveal health consequences linked to smoke/secondhand smoke and newer tobacco products continually being developed, there is a need for upgrading the cessation program.