Outcome and Predictors for Smoking Cessation in a Quit Smoking Clinic



Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.

Keywords:  Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis

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Naghavi, M., Wang, H., Lozano, R., Davis, A., Liang, X., Zhou, M, & Aziz, M. I. A. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 385(9963), 117-171.

World Health Organization. WHO global report on trends in prevalence of tobacco smoking 2015. 2015

Institute for Public Health (IPH). National Health and Morbidity Survey 2015 – Report on Smoking Status Among Malaysian Adults. 2015

Institute for Public Health (IPH) Report of the Global Adult Tobacco Survey (GATS) Malaysia, 2011, Ministry of Health Malaysia. 2012

Satcher, D. Women and smoking: a report of the Surgeon General 2001

Yach, D. WHO framework convention on tobacco control. The Lancet. 2003; 361(9357), 611.

Mahayiddin, H. A., Mazlan, M., & Bakar, S. A. Clinical Practice Guidelines on treatment of tobacco use and dependence 2003. Putrajaya: Ministry of Health Malaysia. 2003

Yasin, S. M., Moy, F. M., Retneswari, M., Isahak, M., & Koh, D. Timing and risk factors associated with relapse among smokers attempting to quit in Malaysia. The International Journal of Tuberculosis and Lung Disease. 2012; 16(7), 980-985.

Wee, L. H., Shahab, L., Bulgiba, A., & West, R. Stop smoking clinics in Malaysia: characteristics of attendees and predictors of success. Addictive Behaviors. 2011; 36(4), 400-403.

Ezat W.P., Selahuddeen A.A, Aljunid S.M, Zarihah Z. Patterns and predictors of smoking cessation among smokers attending smoking cessation clinics in Peninsular Malaysia. Journal of Community Health. 2008; 14(1), 17-23.

Zhou, X., Nonnemaker, J., Sherrill, B., Gilsenan, A. W., Coste, F., & West, R. Attempts to quit smoking and relapse: factors associated with success or failure from the ATTEMPT cohort study. Addictive Behaviors. 2009; 34(4), 365-373.

El Mhamdi, S., Sriha, A., Bouanene, I., Salah, A. B., Salem, K. B., & Soltani, M. S. Predictors of smoking relapse in a cohort of adolescents and young adults in Monastir (Tunisia). Tobacco Induced Diseases. 2013; 11(1), 1-5.

Su, T. T., Sallehuddin, B. A. B., Murniati, H. H., Swinder, J., Al Sadat, N., & Saimy, I. Factors associated with success or failure of quit attempts: a clinical approach for lung cancer prevention. Asian Pacific Journal of Cancer Prevention. 2012; 13(1), 175-179.

Wu, L., He, Y., Jiang, B., Zuo, F., Liu, Q., Zhang, L., & Chan, S. S. Effectiveness of additional follow-up telephone counseling in a smoking cessation clinic in Beijing and predictors of quitting among Chinese male smokers. BMC Public Health. 2016; 16(1), 1.

Hagimoto, A., Nakamura, M., Morita, T., Masui, S., & Oshima, A. Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1‐year follow‐up study. Addiction. 2010; 105(1), 164-173.

Caraballo, R. S., Kruger, J., Asman, K., Pederson, L., Widome, R., Kiefe, C. I., & Jacobs, D. R. Relapse among cigarette smokers: the CARDIA longitudinal study-1985–2011. Addictive Behaviors. 2014; 39(1), 101-106.

Cahill, K., Stevens, S., Perera, R., & Lancaster, T. Pharmacological interventions for smoking cessation: an overview and network meta‐analysis. The Cochrane Library. 2013

Yasin, S. M., Retneswari, M., Moy, F. M., Taib, K. M., Isahak, M., & Koh, D. Testing the Transtheoretical Model in Predicting Smoking Relapse among Malaysian Adult Smokers Receiving Assistance in Quitting. Asian Pacific Journal of Cancer Prevention. 2013; 14(4), 2317-2323.

Borland, R., Yong, H. H., Balmford, J., Cooper, J., Cummings, K. M., O'Connor, R. J, & Fong, G. T. Motivational factors predict quit attempts but not maintenance of smoking cessation: Findings from the International Tobacco Control Four country project. Nicotine & Tobacco Research. 2010; 12(suppl 1), S4-S11.

Pisinger C, Vestbo J, Borch-Johnsen K, et al. It is possible to help smokers in early motivational stages to quit. The Inter99 study. Preventive Medicine. 2005; 40:278–84.


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