Predictors of smoking cessation in Thai patients

Abstract

Background: Treating tobacco dependence depends on numerous factors such as patient socio-demographic characteristics, types of pharmacotherapy, dosage regimens, and duration of therapy. Currently no studies have been conducted to evaluate the predictors of smoking cessation in Thai patients. Objectives: To determine the predictors and multivariate predictors model of smoking cessation in terms of 7-day point prevalence and continuous abstinence rates at 24 weeks in Thai patients. Methods: Correlational research was conducted by collecting data from medical records as prospective and retrospective fashions during October 1, 2004 to January 31, 2007 at outpatients smoking cessation clinics of Thanyarak Institute, Rajavithi Hospital and Ramathibadi Hospital. Data of 454 patients and 249 patients were used to analyze the predictors and multivariate model of smoking cessation, respectively. Results: Predictors analyzed by univariate logistic regression for higher 7-day point prevalence abstinence rates at 24 weeks were: increasing age, married/living with partner statuses, widowed/divorced/separated statuses, bachelor’s degree graduate or upper, concurrent chronic illnesses, smoked 11-20 cigarettes per day, smoked at least 11 years, one previous quit attempt, [is more than or equal to] 2 previous quit attempt, at least 7 sessions of visiting the clinician, types of pharmacotherapy and duration of using pharmacotherapy. Predictors for higher continuous abstinence rates were: all above predictors for 7-day point prevalence abstinence, except number of visiting sessions. After performing backward stepwise logistic regression procedures built multivariate logistic regression model, predictors related to 7-day point prevalence abstinence rate were: one previous quit attempt [Odds ratio (OR) = 2.92, 95%CI =1.41-6.06]; [is more than or equal to] 2 previous quit attempts (OR =3.55, 95%CI = 1.37-9.22); used one first or second line pharmacotherapies as part of treatment (OR = 4.57 , 95%CI = 1.55-13.47); used combinations of first and/or second line pharmacotherapies as part of treatment (OR = 6.41, 95%CI = 1.31-31.27). For continuous abstinence rate at 24 weeks, predictors associated with smoking cessation were: one previous quit attempt (OR =2.97, 95% CI = 1.38-6.39); [is more than equal to] 2 previous quit attempts (OR = 3.19, 95% CI = 1.18-8.56); used one of first or second line pharmacotherapies as part of treatment (OR = 4.83, 95%CI = 1.57-14.85); used combinations of first and/or second line pharmacotherapies as part of treatment (OR = 10.29, 95%CI = 2.06-51.45). Conclusions: Patients who had one and [is more than or equal to]2 previous quit attempts, attended [is more than or equal to]7 clinic visits, used one first or second line pharmacotherapies, used combinations of first and/or second line pharmacotherapies, and had longer duration of pharmacotherapy are associated with higher abstinence rates. More research is needed to determine the target patient characteristics and optimal use of pharmacotherapy for the treatment of tobacco dependence.