OBJECTIVES: Smoking is a major cause of cancer but <10% of smokers who attempt successfully quit smoking. This study identifies determinants of continued tobacco use and successful program completion(>4 visits) following smoking cessation treatment in a referral program.

METHODS: A retrospective cohort study was performed using electronic health record data from 2018-2023 collected at tobacco cessation clinic in West Virginia. Participants aged ≥ 18 who were current tobacco users at first visit were given individualized treatment plans combining pharmacological and behavioral therapy. Follow-up visits assessed tobacco use cessation status .Comparative analysis was used to compare continued tobacco users vs. non-users and premature dropouts from the program vs successful completers. Multivariable logistic regression modelling was conducted to identify determinants of continued tobacco use and program completion.

RESULTS: Of the 407 participants in the study, 332 (81.57%) continued tobacco use on the last visit date, with 346 (85.01%)having >4 visits. Continued tobacco users had fewer overall median and higher baseline tobacco pack-years (51.07(±30.84) vs. 44.42(±22.than those who discontinued. The regression model indicated that females and individuals with cancer were less likely to continue tobacco use than males (OR: 0.78; 95% CI: 0.44 – 1.41, p=0.41) and those without cancer (OR: 0.81; 95% CI: 0.48 – 1.38, p=0.43). While alcohol users have a higher likelihood of continued tobacco use than non-users (OR: 1.41; 95% CI: 0.77 – 2.58, p=0.27). The odds of successful program completion were lower in alcohol users (OR:0.46; 95% CI: 0.25 – 0.85, p=0.01) and higher in cancer patients (OR: 2.89; 95% CI: 1.41 – 5.95, p=0.004).

CONCLUSIONS: Continued tobacco use is associated with male, alcohol use, and non-cancer patients. Whereas program completion is associated with no alcohol use and cancer patients. The study underscores the importance of targeted specialized approaches in cessation programs to effectively assist individuals in quitting tobacco.