RESEARCH PAPER
 
KEYWORDS
TOPICS
* Contributed equally + Co-first authors
ABSTRACT
Introduction:
China has the largest number of smokers in the world. The great majority of China’s smokers desire to quit smoking (QS); however, the success rate of self-quitting is low. This study investigated the effects of smoking cessation (SC) clinics in a cancer hospital in Hunan province and determined the influencing factors of successful SC.

Methods:
Smokers were recruited to QS by healthcare workers in the SC clinic from February 2015 to February 2019. SC counseling was provided and telephone follow-up was conducted at 1 week, and at 1, 3 and 6 months. Patients who continued SC during the follow-up period were considered to have QS.

Results:
Of the 344 patients included in this study, 16.3% QS at one week, 26.5% at one month, 27.6% at three months, and 31.7% at six months. Age ≥60 years, previous SC attempts, immediate quit dates, and telephone follow-up times (3–4 calls) were predictive factors for smokers to SC at six months.

Conclusions:
Age, previous attempts to QS, immediate quit dates and telephone follow-up times were independent predictors of SC success at six months. SC clinics and frequent telephone follow-up improve the success rate of SC, especially in patients who have previously tried to QS or in those who set immediate quit dates.

ACKNOWLEDGEMENTS
We thank R. H. Y. of the School of Xiangya Public Health, Central South University who guided the data analysis. We are grateful to Editage (www.editage.com) for English language editing.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
This research was funded by Hunan Provincial Bureau of Science and Technology (Grants: 2021ZK4069, 2021ZK4076, 2021ZK4078), Hunan Philosophy and Social Sciences Planning Fund (Grant: 20WTC08) and the Changsha Science and Technology Bureau in China (Grant: kq1901085).
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval (Approval number: KYJJ 094; March 1, 2019) was obtained from the ethics committee of the Hunan Cancer Hospital in Hunan Province, China. This study was conducted according to the Declaration of Helsinki. All patients provided oral informed consent.
DATA AVAILABILITY
The data supporting this research are available from the authors on reasonable request.
AUTHORS' CONTRIBUTIONS
Conceptualization JX, RZ, YZ and YL; methodology XC; software JX and RZ; validation, formal analysis, investigation, resources, all authors; data curation JC, LZ, RZ, LZ and XY; writing/original draft preparation JX; writing/review and editing RZ, YZ and YL; visualization, supervision WW, OC and YZ; project administration, funding acquisition, YL, OC and YZ. All authors have read and agreed to the published version of the manuscript.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (35)
1.
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention (US); 2014. Accessed October 27, 2021. https://www.ncbi.nlm.nih.gov/b...
 
2.
Chinese Center for Disease Control and Prevention. Global Adult Tobacco Survey in China in 2018. 2019. Accessed January 14, 2021. http://www.chinacdc.cn/jkzt/st...
 
3.
Chen Z, Peto R, Zhou M, et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. 2015;386(10002):1447-1456. doi:10.1016/S0140-6736(15)00340-2.
 
4.
Pirie K, Peto R, Reeves GK, Green J, Beral V. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013;381(9861):133-141. doi:10.1016/S0140-6736(12)61720-6.
 
5.
Chinese Association on Tobacco Control. Global Adult Tobacco Survey in China in 2010. In Chinese. Accessed December 14, 2021. http://www.catcprc.org.cn/inde...
 
6.
2008 PHS Guideline Update Panel, Liaisons, and Staff. Treating tobacco use and dependence: 2008 update U.S. Public Health Service Clinical Practice Guideline executive summary. Respir Care. 2008;53(9):1217-1222. Accessed October 27, 2021. http://rc.rcjournal.com/conten...
 
7.
Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017;3(3):CD001292. doi: 10.1002/14651858.CD001292.pub3.
 
8.
Wu L, He Y, Jiang B, et al. 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. doi:10.1186/s12889-016-2718-5.
 
9.
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. doi:10.1111/j.1360-0443.2009.02735.x
 
10.
Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6 Suppl 2:S57-S62. doi:10.1136/tc.6.suppl_2.s57
 
11.
Li L, Feng G, Jiang Y, Yong HH, Borland R, Fong GT. Prospective predictors of quitting behaviours among adult smokers in six cities in China: findings from the International Tobacco Control (ITC) China Survey. Addiction. 2011;106(7):1335-1345. doi:10.1111/j.1360-0443.2011.03444.x
 
12.
Abdullah AS, Mak YW, Loke AY, Lam TH. Smoking cessation intervention in parents of young children: a randomised controlled trial. Addiction. 2005;100(11):1731-1740. doi:10.1111/j.1360-0443.2005.01231.x.
 
13.
Control Office of Chinese Center for Disease Control and Prevention. Guidelines for Smoking Cessation Clinics. In Chinese. People’s Medical Publishing House Co; 2008:60-89.
 
14.
World Health Organization. Guidelines for controlling and monitoring the tobacco epidemic. World Health Organization; 1998. Accessed October 27, 2021. https://apps.who.int/iris/bits...
 
15.
Prochaska JO, Goldstein MG. Process of smoking cessation. Implications for clinicians. Clin Chest Med. 1991;12(4):727-735.
 
16.
Hu Y, Xie J, Chang X, et al. Characteristics and Predictors of Abstinence Among Smokers of a Smoking Cessation Clinic in Hunan China. Front Public Health. 2021;9:615817. doi:10.3389/fpubh.2021.615817
 
17.
Hale JW, Lewis C, Nazir N, et al. One-Time Education Sessions to Help American Indian Smokeless Tobacco Users Quit. J Community Health. 2020;45(3):526-533. doi:10.1007/s10900-019-00771-1.
 
18.
Monsó E, Campbell J, Tonnesen P, Gustavsson G, Morera J. Sociodemographic predictors of success in smoking intervention. Tob Control. 2001;10(2):165-169. doi:10.1136/tc.10.2.165.
 
19.
Srivastava S, Malhotra S, Harries AD, Lal P, Arora M. Correlates of tobacco quit attempts and cessation in the adult population of India: secondary analysis of the Global Adult Tobacco Survey, 2009-2010. BMC Public Health. 2013;13:263. doi:10.1186/1471-2458-13-263
 
20.
Ho KS, Choi BW, Chan HC, Ching KW. Evaluation of biological, psychosocial, and interventional predictors for success of a smoking cessation programme in Hong Kong. Hong Kong Med J. 2016;22(2):158-164. doi:10.12809/hkmj154549
 
21.
Tucker JS, Shadel WG, Golinelli D, Seelam R, Siconolfi D. Motivation to quit cigarettes and alternative tobacco products: prevalence and correlates among youth experiencing homelessness. J Behav Med. 2020;43(2):318-328. doi:10.1007/s10865-019-00092-7
 
22.
Jardin BF, Carpenter MJ. Predictors of quit attempts and abstinence among smokers not currently interested in quitting. Nicotine Tob Res. 2012;14(10):1197-1204. doi:10.1093/ntr/nts015
 
23.
Evans AT, Peters E, Shoben AB, et al. Cigarette Graphic Warning Labels Are Not Created Equal: They Can Increase or Decrease Smokers' Quit Intentions Relative to Text-Only Warnings. Nicotine Tob Res. 2017;19(10):1155-1162. doi:10.1093/ntr/ntw389.
 
24.
Girvalaki C, Filippidis FT, Kyriakos CN, et al. Perceptions, Predictors of and Motivation for Quitting among Smokers from Six European Countries from 2016 to 2018: Findings from EUREST-PLUS ITC Europe Surveys. Int J Environ Res Public Health. 2020;17(17):6263. doi:10.3390/ijerph17176263.
 
25.
Chaiton M, Diemert L, Cohen JE, et al. Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open. 2016;6(6):e011045. doi:10.1136/bmjopen-2016-011045.
 
26.
Li L, Borland R, Yong HH, et al. Predictors of smoking cessation among adult smokers in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia Survey. Nicotine Tob Res. 2010;12 Suppl(Suppl 1):S34-S44. doi:10.1093/ntr/ntq030.
 
27.
Zhu WH, Yang L, Jiang CQ, et al. Characteristics of smokers and predictors of quitting in a smoking cessation clinic in Guangzhou, China. J Public Health (Oxf). 2010;32(2):267-276. doi:10.1093/pubmed/fdp107.
 
28.
West R, Sohal T. "Catastrophic" pathways to smoking cessation: findings from national survey. BMJ. 2006;332(7539):458-460. doi:10.1136/bmj.38723.573866.AE.
 
29.
Zhu N, Lin S, Cao C, Xu N, Yu X, Chen X. Nomogram to predict successful smoking cessation in a Chinese outpatient population. Tob Induc Dis. 2020;18(October). doi:10.18332/tid/127736.
 
30.
Esmer B, Sengezer T, Aksu F, Özkara A, Aksu K. Clinical, sociodemographic and tobacco-use factors associated with smoking cessation rates at three years follow-up, Ankara, Turkey. Tob Prev Cessat. 2019;5(December). doi:10.18332/tpc/114082.
 
31.
Sherman SE, Link AR, Rogers ES, et al. Smoking-Cessation Interventions for Urban Hospital Patients: A Randomized Comparative Effectiveness Trial. Am J Prev Med. 2016;51(4):566-577. doi:10.1016/j.amepre.2016.06.023.
 
32.
Fidan F, Pala E, Ünlü M, Sezer M, Kara Z. Factors Affecting Smoking Cessation and Success Rates of The Treatment Methods Used. Sigara Bırakmayı Etkileyen Faktörler ve Uygulanan Tedavilerin Başarı Oranları. The Medical Journal of Kocatepe. 2005;6(3):27-34. Accessed October 27, 2021. https://dergipark.org.tr/en/do...
 
33.
Aung MN, Yuasa M, Moolphate S, et al. Effectiveness of a new multi-component smoking cessation service package for patients with hypertension and diabetes in northern Thailand: a randomized controlled trial (ESCAPE study). Subst Abuse Treat Prev Policy. 2019;14(1):10. doi:10.1186/s13011-019-0197-2.
 
34.
Pirompanich P, Jirapramukpitak T, Saiphoklang N, et al. Assessment of a New Smoking Cessation Program at Thammasat University Hospital, Pathum Thani, Thailand. Southeast Asian J Trop Med Public Health. 2017;48(2):421-428. Accessed October 27, 2021. https://pubmed.ncbi.nlm.nih.go...
 
35.
Louwagie GM, Okuyemi KS, Ayo-Yusuf OA. Efficacy of brief motivational interviewing on smoking cessation at tuberculosis clinics in Tshwane, South Africa: a randomized controlled trial. Addiction. 2014;109(11):1942-1952. doi:10.1111/add.12671.
 
eISSN:1617-9625