Effectiveness of tobacco cessation interventions and risk factors for tobacco-use relapse: A cohort study

Background Tobacco cessation interventions are a cost-effective way of reducing ill health due to tobacco, as quitting unaided is difficult. There is limited data from India on the success of these strategies. We assessed effectiveness of tobacco cessation strategies in our tobacco cessation clinic (TCC) and the risk factors for smoking relapse. Methods We did an observational study between April 2017 and January 2020 in a tertiary care teaching hospital in Bengaluru, India. All adults who visited the Department of Pulmonary Medicine or TCC were enrolled in the study. A pilot-tested, semi-structured, standardized questionnaire including basic demographics, smoking/tobacco usage, and treatment history, the Fagerström test for nicotine dependence, motivation stage assessment, and a history of adverse drug reactions was administered to the study participants. Results A total of 135 participants were screened, and 127 were recruited. However, only 121 participants were available for the 6-month follow-up. The mean (standard deviation [SD]) age of the participants was 51.7 (14.4) years, and only 2/127 (1.57%) were women. At follow-up, 28/121 (23.14%) participants reported having quit smoking, and 90/121 (74.38%) reported reduced tobacco use. Behavioural counselling (BC) only (65.35%), followed by a combination of BC and nicotine replacement therapy (33.07%), were the commonly used interventions. No significant predictor of relapse/treatment failure was identified. Conclusion Although the quit rate was low, the number of subjects who reduced tobacco usage was high, thereby suggesting the positive role of TCCs in tobacco cessation. BC alone was the most prescribed intervention, although a combination therapy is recommended.