Smoking Cessation Treatment Outcomes in Men and Women in Taiwan: Implications for Interpreting Gender Differences in Smoking Cessation

Several clinical trials of both behavioural and pharmacological treatments across Europe and the US have reported lower smoking cessation rates in women than in men, while population data and data from smokers attending routine stop-smoking services show little or no gender differences in outcome. Data from countries with a large gender difference in smoking prevalence can clarify whether self-selection could be responsible for this discrepancy. We analyzed data from a smoking cessation clinic in Taiwan, where 47% of men and 4% of women smoke. 1,090 smokers (963 men and 127 women) seeking help at a Taiwanese smokers’ clinic between 2002 and 2007 received nicotine patches and up to 8 support sessions. Several baseline variables were collected together with self-reported smoking status at 3 and 6 months. Sustained abstinence rates (abstinent at both 3 months and 6 months) were significantly lower in women than in men (18.0% vs 30.3%, p=0.04), as were point-prevalence abstinence rates at both 3 (28.3% vs 38.5%, p=0.026) and 6 months (22.0% vs 35.0%, p=0.004). In a multiple regression including all baseline variables, only gender and cigarettes per day were significant predictors of sustained abstinence. In conclusion, among a cohort of treatment-seekers in Taiwan, there was a significant gender difference in smoking cessation outcomes. Given that such an effect is small or non-existent in countries where the prevalence of smoking across genders is similar, this suggests that sporadic gender differences could be an artifact of self-selection.