title: Tobacco cessation outcomes in a cohort of patients attending a chest medicine outpatient clinic in Bangalore city, southern India.
abstract: OBJECTIVE
  Nicotine dependence is a widely prevalent and harmful chronic addictive disorder. Quitting tobacco use is however, uncommon in India. We present long-term treatment outcomes of out-patient, tobacco cessation treatments from a specialty clinic setting in southern India.
  
  
  METHODS
  Patients seen in a tobacco cessation clinic were characterized for tobacco use, nicotine dependence and motivation for quitting and offered pharmacologic/non-pharmacologic treatment. They were subsequently contacted telephonically at a mean (±standard deviation) of 24 (±9.1) months to assess tobacco cessation outcome defined as 'point prevalence of 1-month abstinence' by self-reporting.
  
  
  RESULTS
  The mean age of participants was 48.0 ±14.0 yr. Tobacco use distribution was: beedis only (22%), cigarettes only (49%), beedis and cigarettes (18%), chewing only (2%), and smoking and chewing (9%). Two-thirds had high level of nicotine dependence. Of the 189 patients enrolled, only 15 per cent attended follow up clinics. Only 106 (56%) patients were successfully contacted telephonically and 83 (44%) were lost to follow up. Self-reported point prevalence abstinence was 5 per cent by 'intent-to-treat' analysis and 10 per cent by 'responder' analysis. Two clinical parameters - high level of nicotine dependence [estimated by the heaviness of smoking index (HSI)] and the absence of vascular or other chronic disease were found to be associated with successful quitting; these were however, not significant on multivariate analysis.
  
  
  CONCLUSIONS
  Our study has identified low quit-rates in a cohort of patients attending a hospital-based tobacco cessation clinic. In the absence of clear-cut predictors of cessation with low quit-rates, there should be continued efforts to improve cessation outcomes and identify predictors for action.
authors.affiliation: Division of Epidemiology, St John's Research Institute, Bangalore, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Mony
authors.forename: D P
authors.initials: DP
authors.lastname: Rose
authors.forename: P
authors.initials: P
authors.lastname: Sreedaran
authors.forename: G
authors.initials: G
authors.lastname: D'Souza
authors.forename: K
authors.initials: K
authors.lastname: Srinivasan
mesh_terms: D000554:Ambulatory Care Facilities; D002947:Cities; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D020340:Tobacco Use Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D016896:Treatment Outcome