Long-term telephone follow-up of older adults attending a smoking cessation clinic in Türkiye: a retrospective cohort study.

Abstract

Background: Smoking cessation remains beneficial in later life, yet long-term information on smoking status and cessation experiences among older adults attending smoking cessation services is limited. This study descriptively evaluated long-term smoking status and cessation experiences in older adults previously attending a smoking cessation clinic.

Methods: This study used a retrospectively identified cohort with a one-time long-term telephone outcome assessment. Medical records of adults aged ≥ 60 years who attended a smoking cessation outpatient clinic between January 2015 and March 2020 were reviewed, and telephone follow-up was conducted in October 2024, approximately 4.6-9.8 years after clinic attendance. The primary outcome was self-reported smoking status at interview. Recorded treatment modality reflected the treatment plan documented at baseline; medication initiation, duration, and adherence were not available. Multivariable analyses were exploratory.

Results: Of 297 eligible participants, 26 (8.8%) were recorded as deceased. Among the remaining 271 participants, 97 (35.8%) were interviewed. Of these 97 respondents, 35 (36.1%) reported that they were not currently smoking at interview, representing a respondent-only estimate. Under extreme-case assumptions for the 174 non-contacted participants, the proportion not currently smoking ranged from 12.9% to 77.1%. Forty-three respondents (44.3%) reported a longest smoking-free period of ≥ 12 months, although its timing relative to follow-up was unknown. No robust association between recorded treatment modality and smoking status was identified: the overall respondent-only model was not statistically significant, and the treatment-modality association was not retained in the extreme-case sensitivity analysis. Among the 62 respondents currently smoking, 50 (80.6%) expressed willingness to receive support for another quit attempt.

Conclusions: Long-term smoking-status estimates were substantially limited by loss to follow-up and should be interpreted as respondent-only findings rather than as an abstinence rate for the original cohort. The treatment-modality analyses were exploratory and do not support comparative treatment-effectiveness conclusions. The high willingness to attempt quitting again among respondents who were still smoking highlights the potential for continued re-engagement with cessation care in later life.