The physician's intervention in smoking cessation: Results of the five years of smoking cessation clinic

Abstract

Background: Cigarette smoking poses a major burden to society in terms of morbidity, mortality and cost. Interventions aimed at getting smokers to quit are among the most cost-effective uses of healthcare resources. Since we are physicians of a country in which approximately half of the population are smokers and since we believe the role of physician is to motivate and assist their patients to stop smoking, we established a smoking cessation clinic (S.C.C.) in our department at the end of 1992. In this study we aimed to evaluate the smoking cessation trials, quitting rates and analysis of characteristics of 296 patients (110 females and 186 males), followed in the SCC during last five years. Methods: The program of SCC was completed in five visits by smokers. In the first visit, the smoking and health history of smokers were obtained, a physical examination was done and laboratory investigations (L.I.) were planned. In the second visit results of LI's were discussed, reasons for quitting were listed, and nicotine dependence of smokers was evaluated, cessation methods and quitting date were decided. In the third visit (end of the first week of cessation), in the fourth visit (one month after quitting), in the fifth visit (one year after cessation) patients abstinence was checked. Results: 69% of patients consulted in SCC tried to quit smoking, 14% of patients began smoking again in the first month, 15% of patients began smoking again after the first month. Overall one-year maintained quitting rate was 40% in our patients. Nicotine withdrawal symptoms such as crave to smoke (24%), increased appettite and weight gain (15%), irritability and anxiety (16%) and friends attitudes in social events (19%) were the most stated reasons for the relapses of smoking. Conclusion: The high smoking cessation rate of our patients might be due to their strong motivation to quit, since they had multiple health complications related to their smoking habit. We plan to continue our program by including biochemical validation (CO level in expired air, and urine cotinine) of smoking status of our patient.