Evaluation of a Community-based Quality Improvement Smoking Cessation Program Using the Ottawa Model During COVID-19

Background: Tobacco smoking remains a major preventable cause of morbidity and mortality worldwide. In Canada, despite substantial declines in national smoking prevalence over the past 2 decades, important regional disparities persist, with some provinces reporting rates above the national average. This study assessed changes in smoking and cessation outcomes among participants in the Prince Edward Island (PEI) Smoking Cessation Program (SCP), adapted from the Ottawa Model for Smoking Cessation (OMSC) during the COVID-19 pandemic. Methods: This pre-post study evaluated the PEI SCP (2019-2021) among participants completing baseline and 6-month follow-up surveys. Primary outcomes were 7-day and 30-day point-prevalence abstinence at 6 months. Results: Of all tobacco users enrolled in the program (n=1,707), a total of 732 (42.9%) responded to both baseline and 6-month surveys. At the 6-month follow-up, 32.2% of participants achieved 7-day point-prevalence abstinence, and 27.5% of responders reported 30-day point-prevalence abstinence. Nicotine dependence level was significantly reduced (p < 0.001), with the proportion of participants in the low Heaviness of Smoking Index (HSI) category increasing from 17.0% at baseline to 48.7% at follow-up. While 66.5% felt that service quality was unaffected by COVID-19, 29.7% reported pandemic-related challenges to quitting, mainly stress (61.0%) and personal life challenges (31.9%). Conclusions: Findings from the PEI SCP showed that about one-third of respondents achieved smoking abstinence at 6 months, despite the COVID-19 pandemic. These results support continued implementation of evidence-based programs like OMSC in community health settings and highlight the program's resilience under constrained healthcare conditions.