Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program

Regina G Moore Ude; R Patti Herring; Mohamed Ismail; Keiji Oda; Khaled Bahjri; Wenes P Reis; Josileide Gaio; Hildemar Dos Santos

doi:10.7759/cureus.41649

Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program

Cureus. 2023 Jul 10;15(7):e41649. doi: 10.7759/cureus.41649. eCollection 2023 Jul.

Authors

Regina G Moore Ude¹, R Patti Herring², Mohamed Ismail³, Keiji Oda⁴, Khaled Bahjri⁵, Wenes P Reis⁶, Josileide Gaio⁶, Hildemar Dos Santos⁷

Affiliations

¹ Health and Human Ecology, California State University, San Bernardino, USA.
² School of Public Heath, Loma Linda University Medical Center, Loma Linda, USA.
³ Internal Medicine, Kaiser Permanente, Riverside, USA.
⁴ School of Public Health, Loma Linda University Medical Center, Loma Linda, USA.
⁵ Clinical Research, New World Medical, Rancho Cucamonga, USA.
⁶ Public Health, Loma Linda University Medical Center, Loma Linda, USA.
⁷ Preventive Care, Loma Linda University School of Public Health, Loma Linda, USA.

Abstract

Introduction As the leading cause of preventable chronic diseases in adults 18 years and older, tobacco usage in the U.S. results in over 20 million premature deaths annually. Current smokers might need extra support on the path to successfully quitting. Aim To evaluate the influence of predictors of smoking-on-smoking cessation in the Freedom From Tobacco Program (FFT) offered by Southern California Permanente Medical Group (SCPMG). Methods This was a quasi-experimental study to evaluate rates of smoking cessation among participants in the FFT program. There were 471 participants in the study. Factors of the Social Ecological Model (SEM) and demographics were examined to determine if they could predict tobacco cessation. The SEM suggests that an individual's behavior is integrated into a network of intrapersonal characteristics, interpersonal processes, institutional factors, community features, and public policy. In particular, the study mainly addressed the institutional factor. It was promoted within a Health Management Organization and the interpersonal process because it was a group intervention. Findings After multiple regression analyses with all predictors from the SEM and demographics, the only significant predictor was the number of previous attempts to quit. Smokers who tried to stop four or more times in the past were 2.6 times (p<0.03) more likely to quit than those who tried fewer times. As we are aware, this was the first time this result was found for programs implemented by Health Management Organizations. The general quit rate at 12 months for the FFT program was 43.1%. Conclusion As the only predictor of quitting in this study was the number of previous attempts to quit smoking, the recommendation is to develop longer-term smoking cessation programs or a longer follow-up to facilitate smokers who relapse to go back and try to quit again. Another recommendation is to identify the main reasons for relapse and try to address these factors in further interventions.

Keywords: freedom from tobacco program; smoking; smoking cessation; social-ecological model; southern california permanente medical group.