title: Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea: A Cross-Sectional Study.
abstract: We identified factors associated with relapse after 6 months of smoking cessation (late relapse) among males of the Republic of Korea. Of the 222,707 smokers who visited public health center-based smoking cessation clinics (SCCs) between January 1, 2009 and mid-December 2009, we included 1720 individuals who successfully completed a 6-month smoking cessation program at an SCC. These participants were selected via a random stratified sampling design and completed an SCC user satisfaction survey between December 31, 2009 and January 6, 2010. Multiple logistic regression was used to identify factors associated with late relapse, and path analysis was employed to explore relationships among these factors. The frequency of late relapse was 21.6% (n = 372). Residence in a metropolitan area, low socioeconomic status, and the use of nicotine replacement therapy (NRT) were associated with statistically significant increases in late relapse, whereas greater access to counseling and more satisfaction with the SCC were associated with reduced late relapse. The path analysis showed that a greater number of cigarettes smoked daily and a younger age at smoking initiation exerted significant indirect effects on late relapse when NRT was employed. Residence in a metropolitan area indirectly prevented late relapse as counseling frequency increased. NRT use, counseling frequency, and SCC user satisfaction were affected by both smoking behavior and socioeconomic status. Relapse prevention efforts should concentrate on increasing both counseling frequency and SCC user satisfaction. Future studies should focus on the effect of NRT on the maintenance of long-term cessation at the population level in real-world settings.
authors.affiliation: From the National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea (EYP, BYJ), Graduate School of Cancer Science & Policy and National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea (MKL, JKO, EHY), Department of Preventive Medicine, School of Medicine; Ewha Medical Research Center; Ewha Womans University, Seoul, Republic of Korea (BMK).
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Park
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Lim
authors.forename: Byung-Mi
authors.initials: BM
authors.lastname: Kim
authors.forename: Bo Yoon
authors.initials: BY
authors.lastname: Jeong
authors.forename: Jin-Kyoung
authors.initials: JK
authors.lastname: Oh
authors.forename: E Hwa
authors.initials: EH
authors.lastname: Yun
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003376:Counseling / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D056910:Republic of Korea; D012111:Residence Characteristics / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data