Predictors of Short-term Relapse after Successful Smoking Cessation among Patients Attending Smoking Cessation Clinics in China, 2019-2021: A Retrospective Cohort Study.

The Chinese government promotes smoking cessation through smoking cessation clinics (SCCs). This study aimed to identify factors associated with relapse and provide evidence to inform interventions that reduce relapse risk. Participants were SCC patients aged ≥ 18 years who enrolled between June 2019 and December 2021, completed follow-up assessments at one and three months, and reported abstinence at one month. Short-term relapse was defined as self-reported smoking at the three-month follow-up. Treatments included counseling, first-line cessation medications, and traditional Chinese medicine (TCM). Logistic regression was used to identify factors associated with short-term relapse. Among 10,724 eligible SCC patients, 11.6% experienced short-term relapse. Factors positively associated with relapse included the number of previous quit attempts (1-5 attempts: <i>OR</i> = 1.422, 95% <i>CI</i>: 1.254-1.613, > 5 attempts: <i>OR</i> = 1.382, 95% <i>CI</i>: 1.057-1.808), high perceived difficulty in quitting ( <i>OR</i> = 1.297, 95% <i>CI</i>: 1.061-1.586), and moderate ( <i>OR</i> = 1.383, 95% <i>CI</i>: 1.174-1.629) or weak ( <i>OR</i> = 1.517, 95% <i>CI</i>: 1.251-1.841) willingness to quit. Factors negatively associated with relapse included having a college degree or higher ( <i>OR</i> = 0.796; 95% <i>CI</i>: 0.650-0.973), high confidence in quitting ( <i>OR</i> = 0.786; 95% <i>CI</i>: 0.629-0.983), and use of TCM ( <i>OR</i> = 0.276; 95% <i>CI</i>: 0.158-0.482). Enhancing self-efficacy in quitting appears crucial for preventing short-term relapse. The use of TCM may reduce relapse risk and warrants further investigation.