title: Smoking cessation treatment and outcomes in medium to heavy cigarette smokers being treated for cancer in Jordan.
abstract: BACKGROUND
  Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan.
  
  
  METHODS
  Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow- up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed.
  
  
  RESULTS
  A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (≤ 10 ppm) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long- term ARs did not reach 7%.
  
  
  CONCLUSIONS
  In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.
authors.affiliation: Cancer Control Office, King Hussein Cancer Center, Amman, Jordan E-mail fhawari@khcc.jo.
authors.forename: Feras Ibrahim
authors.initials: FI
authors.lastname: Hawari
authors.forename: Nour Ali
authors.initials: NA
authors.lastname: Obeidat
authors.forename: Hiba Salem
authors.initials: HS
authors.lastname: Ayub
authors.forename: Sahar Sattam
authors.initials: SS
authors.lastname: Dawahrah
authors.forename: Saif Feras
authors.initials: SF
authors.lastname: Hawari
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007597:Jordan; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000517:prevention & control*