Factors Correlated with Success Rate of Outpatient Smoking Cessation Services in Taiwan.

Wei-Hsin Huang,Betty Chang,Hsin-Yin Hsu,Fong-Ching Chang

doi:10.3390/ijerph15061218

Abstract

Smoking is the leading cause of preventable death. The purpose of this study was to explore the patient’s and physician’s factors that are correlated with smoking cessation success rate. A total of 877 smokers who visited the outpatient smoking cessation services at a medical center in Northern Taiwan were recruited for the study. Phone interviews were carried out six months after the initial visit to evaluate the success rate of smoking cessation. The result showed that the abstinence rate at six-month was 37.7%. By the multivariate logistic regression model, the predictive factors of abstinence were smokers who had a lower Fagerström test for cigarette dependence (FTCD), lower exhaled carbon monoxide (CO) concentration, or who smoked less than 20 cigarettes per day at the first visit. Smokers who had more than one smoking cessation outpatient visit or seen by physicians who, on average, delivered more than one smoking cessation consultations per week also led to a higher success rate. Therefore, we suggest that physicians should put more efforts and encourage follow-up visits for some smokers by knowing their characteristics at the first visit. Furthermore, physicians with more experience in smoking cessation consultation seemed to be more likely to help patients to quit smoking successfully.

Highlights

Lowering smoking rate is still a challenge faced by public health
For the physician’s factors, smokers seen by physicians who average delivered more than one smoking cessation consultations per week were more likely to quit smoking successfully than smokers that were seen by physicians who delivered less than one consultation per week (40.6% vs. 27.6%, p = 0.001)
No correlations were noted for either gender or the duration of physician’s clinical practice with the six-month cessation success rate

Summary

Introduction

Lowering smoking rate is still a challenge faced by public health. Tobacco control in Taiwan implemented MPOWER measures recommended by the WHO, and Taiwan attained the highest scores for a total of four items, namely: monitoring of tobacco use and policies, protection from tobacco exposure, offering help to quit tobacco use, and enforcing bans on tobacco advertising, promotion, and sponsorship [1]. New regulations under the Tobacco Hazard Prevention Act had gone into effect on 11 January 2009. It was considered as a major public health accomplishment in Taiwan where smoking rates among adults over the age of 18 fell from 21.9% in 2008 (male 38.6%, female 4.8%). Since 2002, the Health Promotion Administration (HPA) of the Ministry of Health and Welfare in Taiwan had provided subsidies for smoking cessation services. Each treatment course provides up to eight weeks of medication, counseling, and subsidies for each clinic visit. With only fixed subsidies for smoking cessation medication (NT$ 250 per week), smokers may still have to pay NT$ 550–1250 (US$ 18.3–41.7)

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Discussion

Conclusion