Early abandonment of tobacco cessation consultations at USF do Parque

Abstract

Aim: To characterize patients of smoking cessation program at USF do Parque (ACeS Lisboa Norte), describing their progress throughout the consultations with highlight to the early abandonment rate (percentage of dropouts after the first appointment) and to identify the factors associated with early abandonment. Type of study: Retrospective observational study, based on analysis of clinical records. Location: USF do Parque – ACeS Lisboa Norte. Population: We studied all smokers (83) that enrolled the tobacco cessation program in 2013. Methods: Data were obtained through document analysis of clinical records from tobacco cessation consultations. A comparative analysis was conducted between the two groups of patients according to their behavior after the first appointment – those who dropout the tobacco cessation program after the first consultation versus those who remained in the program – and statistical tests were applied (Chi-Square and Fisher’s Exact Test) with a confidence interval of 95%. Results: Sample comprising 83 smokers, with a slight predominance of males (50.6%) and a mean age of 47.8 years old, most of them holding a graduate degree and employed. The onset of tobacco use dates from adolescence (mean 16.2 years), with current use around 20 cigarettes per day. A moderate level of nicotine dependence was found in 59.0% of smokers. Regarding motivation levels, the moderate level was also predominant (58.7%). Approximately one-third dropped out the program after the first visit (early abandonment). There was a statistically significant association between early abandonment and the variables ‘presence of psychopathology’ (p=0.02) and ‘family problems’ (p=0.03). Conclusions: Intensive smoking cessation programs require continuous, regular and often prolonged contact between physician and smoker, but dropouts are common particularly after the first consultation. In the literature, both psychopathology and family problems were known to be associated with the success of the intervention; however this study showed that they also have a short-term impact on early abandonment. This result emphasises the importance of the first contact between physician and smoker and reflects the need to improve overall assessment of the smoker and to optimise strategies of support and follow-up in order to assure smokers’ attendance.