BACKGROUND: Smoking cessation medication and behavioral counseling increase the likelihood of successful quitting. This study aimed to explore status about adoption of cessation treatment in smoking cessation clinics (SCCs), which may facilitate refinement cessation strategies in China.
METHODS: The data collected when patients visited the clinics and received follow-up. Cessation treatments consists of counseling, counseling with the first-line cessation medication (FLCM, including varenicline, bupropion, and nicotine replacement therapy), or with traditional Chinese medicine (TCM, including acupuncture and Chinese herbal). Counseling were delivered based on the 5As and 5Rs theory model, with recommended duration ≥10 minutes for each session. The degree of nicotine dependence was measured by Fagerström test for cigarette dependence (FTCD) scores. We used pooled data from 2019 to 2023; only patients ≥18 years old were included (N=102,997).
RESULTS: Of the 102,997 patients (Mage= 51.2±15.0 years old, Mean FTCD sore= 4.4±2.5, 96.5% male), the utilization rate of FLCM was only 12.8%. The rate was the highest in the high cigarette dependence group, followed by moderate and low dependence group (19.3%, 13.0% and 8.0% respectively, p-value <0.01). The FLCM utilization were varenicline (5.8%), bupropion (5.1%), nicotine patch (1.5%), and nicotine gum (0.4%). Not covered by national medical insurance and high cost of the FLCM affects the patient's acceptance and the medication equipment in SCCs. SCCs tend to provide the FLCM to patients with high nicotine dependence, considering it is more necessary for them. Although evidence on the role of TCM in cessation is insufficient, some SCCs still use it for treatment for its accessibility. The utilization rate of TCM was 2.0%.
CONCLUSIONS: Counseling plays a major role in cessation treatment in SCCs, and the utilization rate of the FLCM is low in China. Insurance coverage of the FLCM is necessary to increases the availability and utilization for every smoker willing to quit.