Smoking Cessation Rate of Tobacco use Disorder in Patients at Buntharik Hospital, Ubonratchatani Province

Abstract

Background: Tobacco use is common problem in Thailand but accessibility rate of tobacco used disorder is low. In Buntharik hospital, only 35, 54 and 23 patients with tobacco used disorder accessed for treatment in 2015-2017, respectively. After receiving treatment, about 25-35% of the patients were successful in smoking cessation. Lack of guideline for health promotion, prevention, treatment and rehabilitation was assumed to cause low service accessibility rate and low rate of smoking cessation after treatment. There were no criteria for consultation and referral patients between hospital units and outside the hospital. The research team developed a clinical guideline for tobacco used disorder and explore the rate of smoking cessation in the study area. Objective: To explore smoking cessation rate of tobacco used disorder in Buntharik hospital and identify factors associating with smoking cessation in patients with tobacco used disorder. Method: This was a cross-sectional descriptive study aimed to compare smoking cessation rate in patients with tobacco used disorder at Buntharik hospital before and after using clinical guideline for tobacco used disorder in Buntharik district, Ubonratchathani province in one month. Two hundred and thirty-eight participants aged 15 years and above were screened by ASSIST-Thai. The diagnosis was done by clinical diagnosis with F17.1-F17.2 by ICD-10 criteria. Results: After using clinical guideline, total number of patients with tobacco used disorder was 238 with male preponderance (97.9%). Average age was 37.4 years (± SD 18.0). 76.9% of those patients were diagnosed with tobacco abuse (F17.1). One hundred and one patients can stop smoking. Smoking cessation rate in patients with tobacco used disorder increased from 28.6% to 42.4%. Factors associated with smoking cessation in patients with tobacco used disorder were 1) occupation (p = 0.02) 2) smoking fewer than 10 cigarettes per day (p <0.01) 3) intention to quit smoking (p <0.01) 4) had close friends who did not smoke (p <0.01) 5) low risk on ASSIST-Thai scores (p <0.01) 6) people who can stop smoking after receiving guideline-based treatment and follow up in 1 month (p <0.01) 7) motivation to quit smoking (p = 0.02) 8) high frequency of thinking about stop smoking (p = 0.01) 9) no smoking craving (p <0.01) and 10) fewer symptoms of smoking cessation (p <0.01). However, inability to stop smoking longer than 1 week were associated with unsuccessful smoking cessation (p = 0.01). Conclusion: Smoking cessation rate in patients with tobacco used disorder in patients at Buntharik hospital was 42.4% after implementing practice guideline. Factors associated with smoking cessation should be reinforced to help people to stop smoking longer than 1 week which will increase chance of smoking cessation.