Evaluation of biological, psychosocial, and interventional predictors for success of a smoking cessation programme in Hong Kong

Abstract

Introduction: Predictors for smoking cessation have been identified in different studies but some of the predictors have been variable and inconsistent. In this study, we reviewed all the potential variables including medication, counselling, and others not commonly studied to identify the robust predictors of smoking cessation. Methods:This historical cohort study was conducted in smoking cessation clinics in Hong Kong. Subjects who volunteered to come for free treatment between January 2010 and December 2011 were reviewed. Those under the age of 18 years, or who were mentally unstable or cognitively impaired were excluded. Counselling and quit-smoking medications were provided to the participants. The outcome measure was self-reported 7-day point prevalence abstinence rate at week 26. Results: Univariate analysis showed that the following were significant predictors of quitting: (1) psychosocial variables such as feeling stressed, feeling depressed, confidence in quitting, difficulty in quitting, importance of quitting, Smoking SelfEfficacy Questionnaire score; (2) smoking-related variables such as number of cigarettes smoked per day, Fagerström Test for Nicotine Dependence score, number of high-risk situations encountered; (3) health-related variable of having mental illness; (4) basic demographics such as age, marital status, and household income; and (5) interventional variables such as counselling and pharmacotherapy. Multiple logistic regression showed that the independent predictors were age, having mental illness, daily cigarette consumption, Fagerström Test for Nicotine Dependence score, reasons for quitting, confidence in quitting, depressed mood, external self-efficacy, intervention with counselling and medications. Conclusions: This clinic-based local study offers a different perspective on the predictors of quitting. It reminds us to adopt a holistic approach to deal with nicotine withdrawal, to enhance external selfefficacy to resist temptation and social influences, to provide adequate counselling, and to help smokers to cope with mood problems.