Pathway to quit: Strategies for smoking cessation in a resource-limited setting, lesson from Thailand
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Department of Internal Medicine, Khon Kaen Hospital, Khon Kaen, Thailand
Smart Quit Clinic, Out-patient Department, Khon Kaen Hospital, Khon Kaen, Thailand
Department of Statistics, Faculty of Science, Khon Kaen University, Khon Kaen, Thailand
Publication date: 2021-09-02
Corresponding author
Pornanan Domthong   

Department of Internal Medicine, Khon Kaen Hospital, Khon Kaen, Thailand
Tob. Induc. Dis. 2021;19(Suppl 1):A192
Nicotine-replacement therapy (NRT) and adjunct non-NRT pharmacological treatment are most effective tobacco-control treatments worldwide. Unfortunately, the applicability of these approaches to low- and middle-income countries are limited because of their expenses. According to World Bank information in 1999, there were only 0.4% of smokers in Thailand who could be subsidized NRT (comparing to 25%, 18.5%, 15.6% of smokers in Australia, Finland, and United Kingdom, respectively).

We aim to evaluate abstinence rate after setting up Smart Quit Clinic under resource-limited context without providing NRT.

Smart Quit Clinic in Khon Kaen Hospital in Thailand is a program under resource-limited context to help smoking cessation. This program provides individual extensive counseling by specialty trained providers and intensive support, group behavioral therapy, telephone counseling, and minority of non-NRT pharmacological treatment. The primary objective is to find the continuous abstinence rate (CAR) at a 12-month period. Cross sectional study was conducted for 7 months from April to October, 2016. All eligible participants were prospectively follow up until completing the period. Clinical data collection and descriptive statistical analysis were performed.

The study involved 358 participants, of whom 99.4% were male. About 32.7% of the smokers were between 45-54 years old. Of 32.7% was 11-20 pack-years for a quantification of smoking intensity. About 34.7% of them had 6-7 scores tested with the Fagerström Test for Nicotine Dependence. All participants had attended to various non-pharmacologic strategies in Smart Quit Clinic. Only one-fourth of them received non-NRT with Vernonia cinerea. None of them was accessible for other standard non-NRT and NRT. Remarkably, the 12-month CAR was 43.3%.

Although most of pharmacological strategies for smoking cessation programs are less feasible and less affordable in Thailand, a combination of intensive, specialized care, and behavioral modification provided by Smart Quit Clinic achieved considerably high rates of cessation success.

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