Introduction:
The integration of tobacco dependence treatment interventions into routine tuberculosis (TB) services is broadly acknowledged as an important measure to tackle the dual burden of TB and tobacco. The study aimed to explore TB physicians’ practice of tobacco dependence treatment based on the recommended 5 “A’s” model.

Methods:
A cross-sectional study was conducted among TB physicians from inpatient and out-patient TB facilities throughout Armenia. Self-administered questionnaire included questions on demographics, knowledge, attitude, practice and confidence in providing tobacco dependence treatment. The predictors of the high practice score (number of activities always performed during physicians’ daily practice) were assessed using multiple linear regression analysis.

Results:
Overall, 91 TB physicians completed the survey. The mean self-reported practice score was 5.71 (max=15). Majority of TB physicians always asked about smoking status of their patients (72.53%) and always advised smoking patients to quit (93.41%). About half of them always assessed patients’ willingness to quit (54.95%). Conversely, less than half of physicians always assisted their patients in smoking cessation (43.96%) and only few respondents (3.30%) mentioned about always arranging follow-up to review patients’ progress in quitting. Regression analysis revealed that TB physicians’ knowledge on smoking cessation (β=0.22) and monthly number of their patients (β=-0.05) were significantly associated with practice score.

Conclusions:
Recommended interventions were not fully implemented into routine TB services. TB physicians with higher knowledge score on smoking cessation and lower patient load were more likely to have higher practice score. These predictors should be targeted for future interventions improving tobacco dependence treatment practices.