Immediate evidence-based support: Key to quitting smoking in chronic airway disease – A multicenter randomized study

<bold>Introduction:</bold> Chronic airway diseases are adversely affected by tobacco exposure, which often receives insufficient attention. We aimed to examine the impact of immediate appointments to smoking cessation outpatient clinics, scheduled by physicians who primarily care for these patients, on cessation success rates. <bold>Methods:</bold> This multicenter, randomized, parallel-arm, prospective study (<ext-link>NCT05764343</ext-link>) included 384 patients aged 18 years or older diagnosed with COPD, asthma, or bronchiectasis for at least 6 months, presenting to chest outpatient clinics. Patients were sequentially randomized in a 1:1 ratio. Both arms received brief smoking cessation interventions. The intervention arm had immediate access to smoking cessation clinic appointment, while the control arm received standard quitline appointment for routine service. Primary outcome was the rate of self-reported smoking cessation at 3 months. <bold>Results:</bold> The study comprised 194 patients in the immediate intervention arm and 190 in the usual care arm. Quit rate was significantly higher in the immediate intervention arm (26.8%) compared to the usual care arm (15.7%, p:0.008). Access to evidence-based treatments was 71.1% in the intervention group against 23.2% in the control group (p<0.001). Factors negatively impacting the likelihood of quitting smoking were identified as lack of access to evidence-based care (OR: 8.85), being female (OR: 1.96), and an earlier age at smoking initiation (OR: 0.95). <bold>Conclusion:</bold> This study demonstrates that immediate access to evidence-based smoking cessation support significantly increases quit rates in chronic airway disease patients.