Introduction:
Smoking prevalence in Israel is twice as high among the Arab (46%) than among the Jewish population. In the Northern District in Meuhedet approximately 40% of members are Arab. Participants in smoking cessation groups are evenly divided between Arab and Jewish smokers. The Aim of this study was to identify risk factors for relapse among participants in smoking cessation groups in order to establish culturally appropriate support strategies.

Material and Methods:
Between the years 2010-2015, approximately 2,000 members participated in smoking cessation groups in the district. The study population were randomly selected participants who had completed a smoking status questionnaire prior to participation in the group, who had attended the group at least a year prior to the study and who participated in at least 3 group meetings (out of 8). We used a telephone questionnaire consisting of questions regarding current smoking status, and factors associated with abstinence or relapse.

Results:
221 members completed the telephone questionnaire. Self-reported abstinence was significantly higher among Arabs than among Jews (52.2% vs. 39.9%, p<0.01), and among males than females (49.4% vs. 21.6%, p<0.01). As only Arab males participated in smoking cessation groups, we compared between males only and found no significant difference. Likelihood of abstinence was twice as high among those who persisted with smoking cessation medication (p<0.05) and 6 times higher among those who were physically active (p<0.01). Arabs persisted more with medication (94.7% vs. 76.2%, p<0.0001); no difference was found between Arabs and Jews in physical activity. Those who reported a supportive family member were 4 times more likely to remain abstinent, and Arabs were significantly less likely to report this than Jews (16% vs 55%, p<0.001).

Conclusions:
This study demonstrates the need for culturally adapted tailored maintenance programs following smoking cessation interventions.