• Halim Ismail Department of Community Health, Faculty of Medicine, National University of Malaysia, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur Malaysia.
  • Mohd Fathulzhafran Mohamed Hanan Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Hanizah Mohd Yusoff Department of Community Health, Faculty of Medicine, National University of Malaysia, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur Malaysia.
  • Anaanthan Bhuvanendran Pillai Department of Pharmacy, Hospital Tuanku Ja’afar, Jalan Rasah, Bukit Rasah, 70300 Seremban, Negeri Sembilan Malaysia




Smoking cessation clinic, smoking cessation, tobacco smoking


Tobacco smoking is a major public health concern because it is a contributing risk factor of non-communicable diseases. Smoking cessation clinics are an intervention provided by the Ministry of Health Malaysia to help smokers quit smoking. We investigated the characteristics of the attendees of these clinics and the factors contributing to failure to quit smoking among the attendees in a primary health care setting in Malaysia. This was a cross-sectional study using retrospective secondary data from 245 attendees of smoking cessation clinics in the district of Hulu Langat, Malaysia from 2016 to 2017. Purposive sampling was used, and data were analysed using SPSS 22.0. Failure to quit smoking was defined as failure to abstain from tobacco smoking after at least 6 months’ attendance at the smoking cessation clinic. The majority of attendees were middle-aged, male, Malay, had at least secondary school education and were married. The quit smoking failure rate was 61.2%. The factors associated with failure to quit smoking were the clinic attended, being non-Malay, smoking more cigarettes per day, fewer attempts to quit, fewer visits and higher addiction level. The logistic regression model showed that non-Malays and those with higher modified FTND (Fagerström Test for Nicotine Dependence) scores were 49.6 times and 16.2 times more likely to fail, respectively, while smoking for >15 years had a lower failure rate. Emphasis should be placed on non-Malay smokers and smokers with higher FTND scores for better quit smoking outcomes.


Thun MJ, Carter BD, Feskanich D, et al. 50-Year Trends in Smoking-Related Mortality in the United States. N Engl J Med 2013; 368(351-364.

World Health Organization. WHO Report on the Global Tobacco Epidemic, 2017: Monitoring Tobacco Use and Prevention Policies: World Health Organization; 2017.

Malaysia Ministry of Health. National Health & Morbidity Survey 2015 Non‐Communicable Diseases, Risk Factors & Other Health Problems. 2015.

Shafie AA, Hassali MA, Rabi R, et al. Treatment Outcome Assessment of the Pharmacist-Managed Quit Smoking Clinic in Malaysia. Journal of Smoking Cessation 2016; 11(4): 203-210.

Ezat W, Selahuddeen A, Aljunid S, et al. Pattern and Predictors of Smoking Cessation among Smokers Attending Smoking Cessation Clinics in Peninsular Malaysia. Journal of Community Health 2008; 14(1): 17-23.

Çetinkaya PD, Turan A, Zerman N, et al. Smoking Cessation Rates by Method Used to Quit at One Year among Patients Attending a Smoking Cessation Clinic in Turkey. The Southeast Asian Journal of Tropical Medicine and Public Health 2018; 49(879-886.

Tin TS, Sallehuddin BAB, Murniati HH, et al. Factors Associated with Success or Failure of Quit Attempts: A Clinical Approach for Lung Cancer Prevention. Asian Pacific Journal of Cancer Prevention 2012; 13(1): 175-179.

Mohammad NI, Ghazali S, Shafei MN. Predictors of Successfully Quitting Smoking among Smokers Registered at the Quit Smoking Clinic at a Public Hospital in Northeastern Malaysia. Family Medicine and Community Health 2018; 6(4): 178-183.

Zainal MA, Kadir H, Abd MR. Outcome and Predictors for Smoking Cessation in a Quit Smoking Clinic. International Journal of Public Health Research 2017; 7(1): 774-782.

Mahayiddin H, Mazlan M, Bakar S. Clinical Practice Guidelines on Treatment of Tobacco Use and Dependence 2003. Putrajaya: Ministry of Health Malaysia

Wee LH, Shahab L, Bulgiba A et al. Stop Smoking Clinics in Malaysia: Characteristics of Attendees and Predictors of Success. Addictive behaviors 2011; 36(4): 400-403.

El Mhamdi S, Sriha A, Bouanene I, et al. Predictors of Smoking Relapse in a Cohort of Adolescents and Young Adults in Monastir (Tunisia). Tobacco induced diseases 2013; 11(1): 12.

Ghani WMN, Razak IA, Yang YH, et al. Factors Affecting Commencement and Cessation of Smoking Behaviour in Malaysian Adults. BMC Public Health 2012; 12(1): 207.

Villanti AC, Bover MMT, Gundersen DA, et al. Reasons to Quit and Barriers to Quitting Smoking in Us Young Adults. Family Practice 2016; 33(2): 133-139.

Walker JF, Loprinzi PD. Longitudinal Examination of Predictors of Smoking Cessation in a National Sample of Us Adolescent and Young Adult Smokers. Nicotine & Tobacco Research 2014; 16(6): 820-827.

Yasin SM, Moy FM, Retneswari M, et al. Timing and Risk Factors Associated with Relapse among Smokers Attempting to Quit in Malaysia. The International Journal of Tuberculosis and Lung Disease 2012; 16(7): 980-985.

Li L, Borland R, Yong HH, et al. Predictors of Smoking Cessation among Adult Smokers in Malaysia and Thailand: Findings from the International Tobacco Control Southeast Asia Survey. Nicotine & Tobacco Research 2010; 12(suppl_1): S34-S44.

Charan J, Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian journal of psychological medicine 2013; 35(2): 121.

Picco L, Subramaniam M, Abdin E, et al. Smoking and Nicotine Dependence in Singapore: Findings from a Cross-Sectional Epidemiological Study. Ann Acad Med Singapore 2012; 41(8): 325-334.

Department of Statistic Malaysia. Population and Housing Census, Malaysia 2010 (2010 Census), Population Distribution and Basic Demographic Characteristic Report 2010, Dept. Of Statistics Malaysia. Malaysia. 2010.

Yang JJ, Song M, Yoon HS, et al. What Are the Major Determinants in the Success of Smoking Cessation: Results from the Health Examinees Study. PloS one 2015; 10(12): e0143303.

Patnode CD, Henderson JT, Thompson JH, et al. Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Review of Reviews for the Us Preventive Services Task Force. Annals of internal medicine 2015; 163(8): 608-621.




How to Cite

Ismail, H., Mohamed Hanan, M. F., Mohd Yusoff, H., & Bhuvanendran Pillai, A. (2023). FACTORS ASSOCIATED WITH FAILURE TO QUIT SMOKING AMONG SMOKING CESSATION CLINIC ATTENDEES IN MALAYSIA. Malaysian Journal of Public Health Medicine, 23(1), 1–10. https://doi.org/10.37268/mjphm/vol.23/no.1/art.844