Long-term outcomes of Smoking Cessation Outpatient Clinic interventions in Recep Tayyip Erdogan University Chest Diseases Department

Objective: Tobacco addiction; It is now quite common globally and is now defined as "epidemic" as it is a risk factor in the development of the most common diseases and contributes significantly to morbidity and mortality. It is of great importance for individuals who smoke to quit smoking and prevent relapse. The success of smoking cessation outpatient clinics will bring tobacco control to the targeted level in our country, by the light of the studies and determination in this regard. The purpose of our study is to assess smoking cessation success in short and long term follow-up of individuals who applied to smoking cessation outpatient clinic, to evaluate smoking cessation success according to the type of pharmacologic treatment, treatment adherence and socio-demographic data of the individuals, by determining the factors affecting the success; to contribute to tobacco control initiatives and planning in our country. Materials and Methods: Patients between the ages of 18 and 76 who applied to the Smoking Cessation Outpatient Clinic of Rize Recep Tayyip Erdogan University Chest Diseases Clinic between January 2018 and May 2019 were examined. Patients who could be contacted after a 2-year period were included in the study, after their smoking history, socio-demographic data, and nicotine addiction levels were determined at the time of first admission and the pharmacological treatment they planned to follow-up was noted. Factors affecting smoking cessation and adherence to treatment were examined using multiple regression analysis. Findings: The mean age of the 425 patients included in the study was 38 ± 12, 73.4% were men and 26.6% were women. The three most common comorbidities were cardiovascular, pulmonary and psychiatric diseases. The patients had an average smoking history of 22.4 ± 16.8 pack / year according to their smoking history, and the patients were 65% high, 13% moderate, and 22% low nicotine addictors according to the Fagerström test score. Varenicline was given to 47% of the patients, nicotine replacement therapy (NRT) to 48%, and both treatments (combined) to 5%. The patients used these pharmacological treatment methods for an average of 44.3 ± 19.4 days. The mean duration of varenicline use was 45.66 ± 19.5 days, the duration of NRT use was 40.48 ± 17.9 days, and the vi duration of combined therapy was 66.5 ± 15.5 days (p <0.05). When the factors related to adherence to treatment were examined by multivariate regression analysis; factors affecting their adherence to treatment are as follows; older age, low Fagerström score, not reporting withdrawal symptoms during treatment, not reporting weight gain-increased appetite-constipation symptoms during treatment, and being successful in quitting smoking. (p <0.05). The smoking cessation status of the patients at the end of the second year was as follows; 20.5% quit, 50.1% never quit, 19.5% quit in the short term but resumed (relapse). The factors affecting smoking cessation are examined in multivariate analysis are as follows; the low Fageström Nicotine Dependency Test score at the time of admission, the long duration of using the planned pharmacological treatment, sleep disturbance-nightmare symptoms during treatment, weight gain-increased appetite-constipation symptoms, not showing withdrawal symptoms and not being student (p <0.05). Results: According to the results of our study that we examined the long-term results of our smoking cessation outpatient clinic, which included two-year follow-ups, the smoking cessation success rate was 20.5%. There was no significant difference between pharmacological treatment options in terms of quitting success or adherence with treatment. Considering the factors that affect smoking cessation success, the standards of smoking cessation outpatient services should be updated.