Factors Influencing Smoking Cessation Success in an Outpatient Clinic: A Cross-Sectional Study

Öz

Objective: Smoking remains a major global health issue, contributing to millions of preventable deaths annually. Effective smoking cessation strategies combine pharmacotherapy and behavioral support, yet real-world data on factors influencing treatment success in outpatient settings, particularly in Türkiye, are limited. The aim of this study was to evaluate the effectiveness of pharmacological treatment in a smoking cessation outpatient clinic and identify factors associated with cessation success. Method: This cross-sectional observational study included 203 adult smokers initiating pharmacological treatment at a tertiary hospital in Istanbul between April and October 2023. After excluding 22 patients lost to follow-up, 181 participants were analyzed. Data were collected via face-to-face interviews, the Fagerström Test for Nicotine Dependence (FTND), and 3-month follow-up calls. Bivariate analyses and multivariate logistic regression identified predictors of cessation success. Results: At 3-month follow-up, 28.6% of participants successfully quit smoking. Significant predictors of cessation included follow-up attendance (OR=0.18, p<0.001), lower nicotine dependence (OR=1.33, p=0.011), combination therapy (bupropion + nicotine replacement therapy; p=0.001), and employment status (OR=0.39, p=0.036). Age, gender, education, and income were not significantly associated with outcomes. Conclusion: Pharmacotherapy, particularly combination therapy, combined with follow-up visits and tailored to nicotine dependence levels, enhances smoking cessation success. Sustained behavioral support and adherence-focused strategies are critical for optimizing outcomes in clinical practice.

Anahtar Kelimeler

• Smoking Cessation
• Tobacco Use Disorder
• Treatment Outcome
• Pharmacotherapy

Etik Beyan

This study was conducted at the Family Medicine Smoking Cessation Outpatient Clinic of a tertiary care hospital in Istanbul, and was approved by the Clinical Research Ethics Committee of Istanbul Medeniyet University Göztepe Training and Research Hospital with the decision number 2023/0246 dated April 12, 2023. Written informed consent was obtained from all participants. The study was carried out in accordance with the principles of the Declaration of Helsinki.

Sigara Bırakma Polikliniğinde Tedavi Başarısını Etkileyen Faktörler: Kesitsel Bir Çalışma

Öz

Amaç: Sigara kullanımı, her yıl milyonlarca önlenebilir ölüme neden olan küresel bir sağlık sorunudur. Etkili sigara bırakma stratejileri farmakoterapi ve davranışsal desteği birleştirse de, özellikle Türkiye’de ayakta tedavi ortamlarında tedavi başarısını etkileyen faktörler üzerine gerçek dünya verileri sınırlıdır. Bu çalışmanın amacı sigara bırakma polikliniğinde farmakolojik tedavinin etkinliğini değerlendirmek ve bırakma başarısı ile ilişkili faktörleri belirlemektir. Yöntem: Bu kesitsel gözlemsel çalışma, Nisan-Ekim 2023 tarihleri arasında İstanbul’daki bir üçüncü basamak hastanede farmakolojik tedavi başlatan 203 yetişkin sigara içicisini içermiştir. Takipte kaybedilen 22 hasta hariç tutularak, 181 katılımcı analiz edilmiştir. Veriler yüz yüze görüşmeler, Fagerström Nikotin Bağımlılığı Testi (FTND) ve 3 aylık takip aramaları yoluyla toplanmıştır. İkili analizler ve çok değişkenli lojistik regresyon, bırakma başarısının öngörücülerini belirlemiştir. Bulgular: Üç aylık takipte, katılımcıların %28,6’sı sigarayı başarıyla bırakmıştır. Bırakma başarısının anlamlı öngörücüleri arasında takip vizitlerine katılım (OR=0,18, p<0,001), düşük nikotin bağımlılığı (OR=1,33, p=0,011), kombine tedavi (bupropion + nikotin replasman tedavisi; p=0,001) ve istihdam durumu (OR=0,39, p=0,036) yer almıştır. Yaş, cinsiyet, eğitim ve gelir düzeyi ile sonuçlar arasında anlamlı bir ilişki bulunmamıştır. Sonuç: Farmakoterapi, özellikle kombine tedavi, takip vizitleriyle desteklendiğinde ve nikotin bağımlılık düzeyine göre uyarlandığında sigara bırakma başarısını artırmaktadır. Sürekli davranışsal destek ve uyum odaklı stratejiler, klinik uygulamalarda sonuçları optimize etmek için kritik öneme sahiptir.

Anahtar Kelimeler

• Sigara Bırakma
• Tütün Kullanım Bozukluğu
• Tedavi Sonucu
• Farmakoterapi

Etik Beyan

Bu çalışma, İstanbul’daki bir üçüncü basamak sağlık kuruluşunun Aile Hekimliği Sigara Bırakma Polikliniği’nde yürütülmüş olup, İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma Hastanesi Klinik Araştırmaları Etik Kurulu tarafından 12.04.2023 tarihli ve 2023/0246 sayılı karar ile etik kurul onayı alınmıştır. Çalışmaya katılan tüm bireylerden yazılı bilgilendirilmiş onam alınmıştır. Araştırma sürecinde Helsinki Bildirgesi ilkelerine uyulmuştur.

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