TY - JOUR ID - TI - Evaluation and Challenges of a Smoking Cessation Program in the Eastern Mediterranean Region: A Mixed-Method Approach AU - Salwa A. Koubaissi AU - Sarah Jawhar AU - Maya Romani AU - Gladys Honein AU - Jad A. Degheili AU - Nadim Kanj PY - 2021 VL - 18 IS - 4 SP - 377 EP - 386 JO - Medical Journal of Babylon مجلة بابل الطبية SN - 1812156X 23126760 AB - Introduction: Given the lack of studies on tobacco cessation interventions in the Eastern Mediterranean region, this paper presentsfindings from a smoking cessation program (SCP) in a tertiary referral center. The aim is to evaluate the predictors, facilitators, andbarriers associated with successful smoking cessation from both participant and provider perspectives. Materials and Methods: A mixedmethodapproach was used. Part 1 was a retrospective cross-sectional quantitative study with a telephone-based survey conductedon a sample of 47 patients enrolled in the SCP between March 2014 and August 2017. Part 2 was a qualitative study comprising afocus group discussion among five practitioners from the SCP. Results: Only 37% reported being adherent to the prescribed treatmentand 74.5% reported receiving behavioral counseling. In the multivariate logistic regression analysis, adhering to pharmacotherapyincreased the odds of being a quitter at 1 and 6 months after quit date (QD), whereas completing behavioral counseling increasedthe odds of being a quitter at 1, 6, and 12 months after QD. Point prevalence abstinence at 1 month and prolonged abstinence at6 and 12 months after QD were 42.2%, 32.6%, and 24.4%, respectively. The overall relapse rate reached 62.5%. Facilitators andbarriers fell under three subthemes: (1) participant factors; (2) provider factors; and (3) system factors. The most common barriersfor non-compliance to the program were stress factors, nicotine addiction, accessibility and availability of pharmacotherapy, cost ofthe program and medications, and time restrictions. Conclusion: Adherence to pharmacotherapy and receiving behavioral counselingincrease the odds of smoking abstinence maintenance. Success or failed cessation is influenced by several underlying factors operatingon multiple levels and understanding them might help improve tobacco cessation interventions.

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