Impact of establishing a comprehensive tobacco cessation service at a primary healthcare setting in the quit attempts: a quality improvement project.

INTRODUCTION

In 2005, Oman ratified the WHO Framework Convention on Tobacco Control (WHO FCTC), committing to reduce tobacco use through best-practice cessation services, including access to counselling, pharmacotherapy and a toll-free Quitline. However, Oman currently lacks a national cessation programme that fully meets WHO FCTC standards. This study evaluated the impact of implementing a best-practice tobacco cessation service at North Al-Khuwair Health Center (NKHC) on quit attempts among tobacco users.

METHODS

A quality improvement initiative was implemented at NKHC using a Plan-Do-Study-Act approach to establish a best-practice cessation service. The study included all tobacco users attending NKHC from July 2024 to March 2025. Very brief advice was provided at each clinical encounter, and those expressing readiness to quit were enrolled in the specialised cessation clinic, where they received free behavioural and pharmacological support. All participants were followed according to the clinic protocol. The primary outcome was a quit attempt.

RESULTS

Before July 2024, NKHC had no operational cessation service. Between July 2024 and March 2025, 30 tobacco users attended the clinic. Over half (n=17, 56.7%) were over 40 years of age, while 16.7% were younger than 18. Most participants were male (n=29, 96.7%), married (n=23, 76.7%), employed (n=23, 76.7%) and used smoked tobacco products (n=24, 80.0%). Tobacco use frequently occurred at home (n=12, 40.0%) or with friends (n=15, 30.0%). Nearly two-thirds of tobacco users (n=19, 63.3%) were exposed to secondhand smoke. Mental health conditions were reported among 13.3% of users. Nearly half had attempted to quit previously, mostly using the cold turkey method. All participants were asked and advised to quit; 80.0% were ready to quit, and most (88.9%) made a quit attempt.

CONCLUSION

Establishing best-practice tobacco cessation services in primary healthcare can increase readiness to quit and promote quit attempts. Further studies are required to assess quit rates.