Knowledge, attitudes, and practices of community pharmacists on pharmacological approaches to smoking cessation in Saudi Arabia

Pharmacological therapies are key component of effective smoking-cessation management; however, the extent to which community pharmacists are prepared to deliver these interventions remains unclear. This study explored the knowledge, attitudes, and practical engagement of community pharmacists toward pharmacological interventions of smoking cessation, and to examine the influence of demographic factors on these outcomes. A cross-sectional survey was conducted between January and August 2024 among licensed community pharmacists in Saudi Arabia. A structured questionnaire, distributed contained four sections: demographics, knowledge, attitudes, and practices. A total of 213 pharmacists participated (92% male, 80.8% non-Saudi), mostly aged 25–34 years and holding a bachelor’s degree (94.8%). Mean scores indicated moderate levels of knowledge (6.31 ± 2.7/10), attitude (13.07 ± 6.5/25), and practice (6.85 ± 2.1/12) toward smoking cessation. Although nearly one-third of pharmacists (30.5%) consistently referred patients to Ministry of Health cessation programs, routine assessment of smoking status was less common, with only 17.8% regularly asking patients whether they smoked. Reliability was good-to-excellent (α = 0.800–0.951). Knowledge correlated positively with practice (r = 0.203, p = 0.003) but negatively with attitude (r = − 0.244, p < 0.001). Higher knowledge was associated with younger age (p = 0.035). Practice scores were higher among pharmacists from the Northern (p = 0.001) and Eastern regions (p = 0.006), and among those with prior smoking-cessation training (p = 0.012). Community pharmacists in Saudi Arabia demonstrated moderate levels of knowledge, attitudes, and practices related to pharmacological smoking-cessation interventions. Knowledge was positively associated with practice but negatively with attitudes. Practice levels varied significantly by region and were higher among pharmacists who had received prior training, highlighting the importance of targeted professional development and better integration of smoking cessation services into community pharmacy practice.