Association between early treatment response and long-term smoking cessation: A real-world retrospective cohort study of cytisine treatment.
- 1Gülhane Faculty of Medicine, Department of Pulmonary Medicine, Health Sciences UniversityAnkaraTürkiye.
- 2Gülhane Faculty of Medicine, Health Sciences UniversityAnkaraTürkiye.
- 3Faculty of Medicine, Department of Biostatistics, Hacettepe UniversityAnkaraTürkiye.
Abstract
Cytisine is an effective and cost-efficient pharmacotherapy for smoking cessation; however, real-world evidence regarding treatment outcomes within structured behavioral programs remains limited. This study aimed to evaluate short- and mid-term smoking cessation outcomes following cytisine treatment and to identify factors associated with treatment success, with particular emphasis on early treatment response as a marker of long-term abstinence. This retrospective cohort study included 364 consecutive adult smokers who initiated cytisine treatment within a structured smoking cessation program at a tertiary outpatient clinic between April 2023 and February 2025. Smoking abstinence was assessed at 1 and 6 months through outpatient visits and structured telephone interviews recorded in the Turkish National Smoking Cessation Registry System (TUBATIS). Baseline demographic characteristics, nicotine dependence assessed using the Fagerström test for nicotine dependence (FTND), cumulative smoking exposure, and previous smoking cessation treatment were evaluated. Multivariable logistic regression, interaction analyses, receiver operating characteristic (ROC) curve analyses, and Kaplan-Meier survival analyses were performed. Smoking abstinence was achieved by 114 patients (31.3%) at 1 month and 67 (18.4%) at 6 months. Early responders had substantially higher 6-month abstinence rates than early non-responders (49.1% vs 4.4%), and early treatment response was strongly associated with sustained abstinence after multivariable adjustment (AOR=9.8; 95% CI: 4.7-20.5; p<0.001). Lower cumulative smoking exposure (≤20 pack-years) was independently associated with early abstinence (AOR=3.55; 95% CI: 1.99-6.36; p<0.001), whereas sex, nicotine dependence, age, and previous cessation treatment were not independently associated with 1-month abstinence. A significant interaction between nicotine dependence and smoking exposure was observed (p=0.028). A prediction model incorporating early treatment response demonstrated better discrimination for 6-month abstinence than a baseline clinical model (AUC: 0.82 vs 0.68). Early treatment response was strongly associated with sustained smoking abstinence and may represent a clinically useful time point for treatment reassessment. Baseline nicotine dependence and cumulative smoking exposure were also associated with cessation outcomes, supporting individualized risk assessment and follow-up. Cytisine, when combined with structured behavioral support, was associated with clinically meaningful smoking cessation outcomes in this real-world cohort.
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BibTeX
@article{arslan2026association,
title = {{Association between early treatment response and long-term smoking cessation: A real-world retrospective cohort study of cytisine treatment.}},
author = {Yakup Arslan and Burcu Öztürk Şahin and Arzu Aygül and Cansu Yaman and Zeynep Aytül Selimoğlu and Gökberk Sızı and Eljan Heydarov and Ebru Öztürk and Esra Sönmez and Deniz Doğan and Nesrin Öcal and Cantürk Taşçı},
journal = {Tobacco induced diseases},
year = {2026},
month = nov,
doi = {10.18332/tid/241540},
url = {https://europepmc.org/article/MED/42996805},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between early treatment response and long-term smoking cessation: A real-world retrospective cohort study of cytisine treatment.
AU - Yakup Arslan
AU - Burcu Öztürk Şahin
AU - Arzu Aygül
AU - Cansu Yaman
AU - Zeynep Aytül Selimoğlu
AU - Gökberk Sızı
AU - Eljan Heydarov
AU - Ebru Öztürk
AU - Esra Sönmez
AU - Deniz Doğan
AU - Nesrin Öcal
AU - Cantürk Taşçı
PY - 2026
DA - 2026/11/05
JO - Tobacco induced diseases
DO - 10.18332/tid/241540
UR - https://europepmc.org/article/MED/42996805
AB - Cytisine is an effective and cost-efficient pharmacotherapy for smoking cessation; however, real-world evidence regarding treatment outcomes within structured behavioral programs remains limited. This study aimed to evaluate short- and mid-term smoking cessation outcomes following cytisine treatment and to identify factors associated with treatment success, with particular emphasis on early treatment response as a marker of long-term abstinence. This retrospective cohort study included 364 consecutive adult smokers who initiated cytisine treatment within a structured smoking cessation program at a tertiary outpatient clinic between April 2023 and February 2025. Smoking abstinence was assessed at 1 and 6 months through outpatient visits and structured telephone interviews recorded in the Turkish National Smoking Cessation Registry System (TUBATIS). Baseline demographic characteristics, nicotine dependence assessed using the Fagerström test for nicotine dependence (FTND), cumulative smoking exposure, and previous smoking cessation treatment were evaluated. Multivariable logistic regression, interaction analyses, receiver operating characteristic (ROC) curve analyses, and Kaplan-Meier survival analyses were performed. Smoking abstinence was achieved by 114 patients (31.3%) at 1 month and 67 (18.4%) at 6 months. Early responders had substantially higher 6-month abstinence rates than early non-responders (49.1% vs 4.4%), and early treatment response was strongly associated with sustained abstinence after multivariable adjustment (AOR=9.8; 95% CI: 4.7-20.5; p<0.001). Lower cumulative smoking exposure (≤20 pack-years) was independently associated with early abstinence (AOR=3.55; 95% CI: 1.99-6.36; p<0.001), whereas sex, nicotine dependence, age, and previous cessation treatment were not independently associated with 1-month abstinence. A significant interaction between nicotine dependence and smoking exposure was observed (p=0.028). A prediction model incorporating early treatment response demonstrated better discrimination for 6-month abstinence than a baseline clinical model (AUC: 0.82 vs 0.68). Early treatment response was strongly associated with sustained smoking abstinence and may represent a clinically useful time point for treatment reassessment. Baseline nicotine dependence and cumulative smoking exposure were also associated with cessation outcomes, supporting individualized risk assessment and follow-up. Cytisine, when combined with structured behavioral support, was associated with clinically meaningful smoking cessation outcomes in this real-world cohort.
SN - 2070-7266
SN - 1617-9625
ER -