背景與目的：過去有關戒菸成功率與影響戒菸成功因素的文獻，多數都是探討個人層面的因素，包含每日吸菸量、菸癮程度、年齡等，但對於機構因素的探討訊息較為缺乏，本研究旨在探討我國二代戒菸服務計畫中戒菸服務機構因素與戒菸成功率間之相關性。
方法：本研究採用橫斷性研究設計，研究期間為 2020 至 2022，使用衛生福利部國民健康署醫事機構戒菸服務系統之門診戒菸資料紀錄檔，針對全國戒菸合約醫事機構，包含醫學中心、區域醫院、地區醫院、診所、衛生所、牙醫診所及藥局等7類，參加戒菸服務補助計畫之18歲以上的民眾，並同時納入接受藥物治療者或衛教諮詢者，且完成參加戒菸服務後第 6 個月追蹤訪視的個案。利用二元邏輯斯迴歸模式配合廣義估計方程式，根據個人層面因素（包括年齡、性別、每日吸菸量、吸菸年數、尼古丁成癮程度、同一年度中治療方式和加入療程時的季節）， 計算每次療程的6個月點戒菸成功機率。接著將療程次的點戒菸成功機率歸戶到機構，獲得機構（平均）之戒菸成功機率，並依據機構校正戒菸成功機率的第 20、40、60 和 80 百分位，將機構校正戒菸成功機率分為五個等級，利用序位邏輯斯迴歸分析戒菸服務機構因素與校正戒菸成功機率之相關性。其中戒菸服務機構因素包括戒菸服務機構類別、機構內療程高利用的占比、研究期間機構戒菸服務提供者數、研究期間機構累積服務量、研究期間機構累積失去追蹤數。
結果：本研究共納入 2420家戒菸服務機構（304757 療程次），機構校正戒菸成功機率平均值為 40.50%，中位數為 39.95%。研究發現：與牙醫診所相比，藥局有較高的戒菸成功之勝算（aOR為39.215）；與機構內療程高利用占比最低組相比，以機構內療程高利用占比介於 68 – 83%，有較高的戒菸成功之勝算（aOR 為 2.294），並達統計上顯著；與戒菸服務提供者數最低組相比，戒菸服務提供者數越多，有較高的戒菸成功之勝算（aOR依序為 1.852、5.324），並達統計上顯著；與累積服務量最低組相比，累積服務量≧161 療程次，有較高的戒菸成功之勝算（aOR 為 1.016），雖未達統計上顯著，但累積服務量越高，仍有較高戒菸成功的現象。
結論：戒菸服務藥局、療程高利用的占比越高和戒菸服務提供者數越多越高，有較高的戒菸成功之勝算。戒菸服務機構之間的戒菸成功機率存在差異性，強調針對機構進行的服務改善措施，可以提高機構整體戒菸成功機率。

While individual – level factors are extensively studied, the variability in the effectiveness of smoking cessation services (SCS) across organizations remains unclear. This study aims to explore the correlation between smoking cessation service organization factors and smoking cessation success rate. A secondary analysis of Taiwan's national smoking cessation service system database (2020 – 2022). The study included participants aged 18 and above from various types of location of the smoking cessation service organization. Binary logistic regression models adjusted for individual – level factors, estimated the rate of smoking cessation for each treatment sessions. All sessions used in a year by the same smoker was aggregated, giving rise to totally 2,420 medical organizations used as the analytical unit in this analysis. To analyzed the relationship between medical institutional factors (including type of organizations, treatment session utilization, healthcare worker count, cumulative service volume, and cumulative lost follow – up count) and smoking cessation success rates, using ordinal logistic regression analysis. The results show that participate in smoking cessation programs at pharmacies, higher treatment session utilization and higher provider numbers correlate with higher cessation success odds. Variations in smoking cessation success probability among organization highlight the importance of enhancing internal smoking cessation services to improve overall smoking cessation success rates.

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