Background: Tobacco consumption remains a predominant modifiable risk factor contributing to global morbidity and mortality, with substantial implications for respiratory dysfunction and cardiometabolic disorders. Despite extensive public health initiatives, sustained abstinence rates remain inadequate, largely attributable to entrenched nicotine dependence and complex behavioural and psychosocial determinants.

Objective: To rigorously evaluate the efficacy of a clinical pharmacist–driven intervention model on smoking cessation outcomes, nicotine dependence attenuation, and pulmonary function parameters among active smokers.

Methods: A randomized controlled trial was undertaken involving 100 adult smokers, systematically allocated into an intervention cohort (n = 53) and a control cohort (n = 47). Comprehensive baseline profiling encompassed demographic variables, tobacco use patterns, spirometry indices, lung age estimation, and nicotine dependence quantified via the Fagerström Test for Nicotine Dependence. The intervention arm received structured, stage-oriented behavioural counselling integrated with pharmacotherapeutic management, whereas the control arm was provided standard care. Outcome measures were longitudinally evaluated at baseline and at 3-, 6-, 9-, and 12-month intervals. Statistical analyses were performed using Chi-square tests for categorical variables, independent t-tests for continuous variables, and temporal trend analysis, with significance defined at p < 0.05.

Results: At the 12-month endpoint, the intervention cohort exhibited a statistically significant improvement in cessation outcomes, with higher abstinence rates (65% vs 35%; p = 0.046). Additionally, significant reductions were observed in nicotine dependence severity (p = 0.042), craving intensity (p = 0.025), and withdrawal symptom burden (p = 0.048), alongside notable improvement in lung age indices (p = 0.009). Furthermore, participants in the intervention arm demonstrated enhanced progression across Transtheoretical Model (TTM) stages and significantly greater adherence to counselling protocols (p < 0.05).

Conclusion: Clinical pharmacist–led, structured behavioural and pharmacological interventions significantly augment smoking cessation success, mitigate dependence-related parameters, and promote measurable improvements in pulmonary health indicators. Integration of such pharmacist-driven models into routine healthcare frameworks is strongly warranted to optimize long-term cessation outcomes.

KEYWORDS: Tobacco Cessation, Clinical Pharmacist, Randomized Controlled Trial, Nicotine Dependence, Spirometry, Lung Age.