Determinants of smoking cessation program completion and continued tobacco use in a referral program in West Virginia: An EHR data analysis from 2018-2023.

INTRODUCTION

Smoking is a risk factor for various comorbidities, yet only a few who attempt to quit are successful. This study examined factors associated with program completion (defined as at least four clinic visits) of a tobacco cessation program in West Virginia and identified predictors of continued tobacco use at the last visit.

METHODS

An observational retrospective cohort study analyzed electronic health records (2018-2023) collected from a tobacco cessation clinic. Patients aged ≥18 years with a history of tobacco use received individualized treatment combining pharmacological and behavioral therapy. Follow-up visits assessed cessation progress. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals for predictors of program completion and continued tobacco use.

RESULTS

Among 407 participants, 85% completed at least four clinic visits, but 81.57% continued tobacco use at the last visit. Cancer (AOR=2.77; 95% CI: 1.36-5.65) and hypertension (AOR=3.26; 95% CI: 1.64-6.47) were associated with higher odds of program completion, whereas alcohol use was associated with lower odds of program completion (AOR=0.52; 95% CI: 0.29-0.93). Continued tobacco use was associated with higher tobacco pack-years (AOR=1.01; 95% CI: 1.0-1.02) and lower number of clinic visits (AOR=0.98; 95% CI: 0.96-0.99).

CONCLUSIONS

Alcohol use, cancer, and hypertension were predictors of program completion, while continued tobacco use on the last visit was associated with tobacco pack-years and the number of clinic visits. Despite high program completion, most participants continued using tobacco on the last visit, highlighting the persistent challenge with the poor effectiveness of smoking cessation treatments. Integrating tailored cessation strategies and utilizing chronic diseases as motivational tools could improve the effectiveness of interventions in high-prevalence states like West Virginia.