Association of shared decision-making cessation model and adult smoking cessation rate: A prospective cohort study

It remains unclear whether shared decision-making (SDM) can help smoking cessation. This study aims to determine whether the SDM model increases the 24-week point abstinence rate and medication adherence rate for adult smokers.

This prospective cohort study, conducted between January 2019 and June 2021, enrolled 1268 adult smokers at the outpatient cessation clinic of a national medical center. SDM-integrated counseling was provided to those opting for the SDM cessation model, involving cessation educators and decision aids. Patients who declined the model received cessation medication. The self-reported 7-day point prevalence abstinence rate at week 24, medication adherence rate, and the proportion of participants agreeing to receive pharmacotherapy were measured.

Out of the 1268 participants, 1187 (93.6%) were included in the primary analysis. Of these, 610 (48%) opted for the SDM model. Participants in the SDM group used cessation medication more frequently (83.4% vs 71.9%, p<0.001) and exhibited higher medication adherence (39.1% vs 28.6%, p=0.04). Logistic regression analysis revealed that the SDM group did not demonstrate a significantly higher 7-day point abstinence rate at week 24 (OR=0.89; 95% CI: 0.68-1.15; p=0.37).

The SDM cessation model was positively associated with medication adherence and the proportion of participants using pharmacotherapies. However, the association of SDM with the 7-day point prevalence of abstinence at week 24 was not statistically significant. Longer follow-up studies are needed to understand the association of the SDM intervention with absolute abstinence.