Motives for Quitting Smoking and Reasons for Relapse Among Current Smoking Quitters in Abha City, Saudi Arabia: A Cross-Sectional Study

Background: Tobacco smoking cessation is a complex process influenced by biological, psychological, and social factors. Despite the availability of effective cessation interventions, relapse remains common among smokers attempting to quit. This study aimed to identify factors associated with previous smoking relapse and nicotine dependence among smokers attending anti-smoking clinics in Abha City, Saudi Arabia. Methods: An analytical comparative cross-sectional study was conducted among 330 adult Saudi smokers attending the Abha Anti-smoking Clinic and the Erada Anti-smoking Clinic. Previous smoking relapse was defined as having one or more unsuccessful smoking cessation attempts after a period of abstinence. Data were collected using a structured interviewer-administered questionnaire covering sociodemographic characteristics, smoking history, nicotine dependence, withdrawal symptoms, motives for smoking cessation, and relapse-related factors. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND). Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed. Results: Most participants were male (84.2%) and aged 20–39 years (59.4%). Smoking initiation most commonly occurred between 15 and 20 years of age (68.8%), while 66.4% reported previous quit attempts. Nervousness (84.2%) and stress or tension (74.2%) were the most frequently reported withdrawal symptoms. High and very high nicotine dependence were reported by 26.1% and 14.2% of participants, respectively. High nicotine dependence (AOR = 1.39, 95% CI: 1.15–1.69, p = 0.001) and very high nicotine dependence (AOR = 1.62, 95% CI: 1.21–2.17, p < 0.001) were independently associated with greater odds of previous smoking relapse. Attendance at the Erada Anti-smoking Clinic was associated with lower odds of relapse (AOR = 0.52, 95% CI: 0.29–0.91, p = 0.021). Conclusions: Higher nicotine dependence was independently associated with previous smoking relapse among smokers attending anti-smoking clinics. Comprehensive cessation programs integrating behavioral counseling, pharmacological treatment, and sustained follow-up may improve long-term abstinence and reduce relapse.