Factors Associated with Failure of Non-pharmacological Treatment in Smoking Cessation

Abstract

Objective: To identify factors contributing to the failure of non-pharmacological treatment in smoking cessation.  Methods: This prognostic factor research collected retrospective cohort data from the medical records of patients who received treatment at the Fahsai Clinic, Rangsit University, from June 18, 2014, to November 16, 2023. The inclusion criteria were: 1) aged 18 years or older, 2) being current smokers seeking treatment to reduce or quit smoking, and 3) treated with non-pharmacological methods. The study outcome was treatment failure, assessed after completing 6 months of therapy through a phone interview. The factors studied included: 1) general information, such as gender, health issues, having spouses, partners or children, use of alcohol or drugs, and 2) smoking behavior, such as accumulated cigarette consumption, severity of nicotine dependence as assessed using the Heaviness of Smoking Index, and readiness to quit smoking based on the Transtheoretical Model. Multivariable logistic regression was used for association analysis.  Results: The sample consisted of 316 individuals, with 81.33% treatment failure rate. The majority were male (88.61%), with a median age of 21 years and interquartile range of 19-31 years, and having mild and moderate levels of nicotine dependence (47.83 and 44.82, respectively). Factors associated with treatment failure included: 1) severe nicotine dependence (OR: 15.13; 95% CI 1.36-168.62), 2) having readiness to quit in the contemplation stage (OR: 8.49; 95% CI 2.85-25.25), and 3) being female (OR: 3.90; 95% CI 1.14-13.35).  Conclusion: Factors associated with treatment failure in non-pharmacological smoking cessation include severe nicotine dependence, having readiness to quit in the contemplation stage, and being female. Patients with these factors should receive pharmacological intervention for smoking cessation from the start of therapy.