Treatment of nicotine addiction: A single-centre cohort study with cytisine
Aim: This study aimed to describe short- and mid-term smoking cessation outcomes, treatment discontinuation, relapse pattern, and self-reported side effects among patients who initiated cytisine treatment in a single university hospital smoking cessation clinic.
Methods: This prospective cohort study included patients who started treatment with cytisine at a university hospital smoking cessation clinic between 2 May and 31 December 2024. Patients were contacted by telephone at 1, 3 and 6 months to determine their smoking status. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence (FTND). Cigarette-Free Duration analysis was performed using the Kaplan–Meier method.
Results: The mean age of the 201 patients included in the study, who were followed up for six months, was 42.38 ± 15.01 years; 83.1% of these patients were male. Treatment was discontinued in 27.4% of patients on the fifth day due to failure to quit smoking. Smoking cessation rates were 72.6% on day 5, 43.3% after one month, 28.9% after three months and 21.4% after six months. Multivariate logistic regression analysis revealed that the presence of chronic disease was independently associated with successful smoking cessation at six months (OR = 6.60; 95% CI: 1.49–29.17; p = 0.013). The Kaplan–Meier analysis showed that treatment failures were concentrated particularly in the early period. Patients with an FTND score of ≥6 had a significantly shorter duration of smoking cessation (mean 71 days vs. 95 days; log-rank p=0.029).
Conclusion: Although smoking cessation treatment with cytisine can be successful in the short term, relapse is particularly common in the early stages. A high level of nicotine dependence reduces the length of time that a person can abstain from smoking. The higher success rate of quitting among individuals with chronic diseases suggests that smoking cessation counselling during primary care follow-ups for these diseases is an important opportunity. Providing intensive behavioural support in the early stages can increase the success of treatment.
Keywords: Smoking, treatment, cessation, follow-up, relapse
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