This study analyzes the effectiveness of the National Tobacco Control Program (NTCP)'s effectiveness in Castanhal-PA, a Brazilian Amazon city. The program was implemented in 2006 and underwent decentralization in 2018. However, in the context of the Unified Health System (SUS) in the Amazon study, the effective implementation of the tobacco control program is filled with difficulties. So, we analyze the program's offering and retention rates, smoking cessation, population of smoking clients, treatment initiation and completion percentage, and association between sociodemographic variables and treatment outcomes. The study analyzed smoking users through FORMSUS forms from 32 Health Units that had anti-smoking treatment from January 2021 to December 2022. We used linear regression and retrospective descriptive statistical analysis. We also apply the chi-square test to check for differences. We visualized and analyzed the data using Microsoft Office® Excel. A sample of 227 individuals was studied in 2021 and 2022. Most participants were female (60.9%) and 60 or older (40.0%). About 47.9% reported having 02 to 03 minimum wages. Smoking was prevalent, with 40% smoking more than 04 cigarettes per day and 116 individuals smoking for more than 20 years. There was a high dropout rate from the NTCP in both years (71.87% and 70.99%). The variables "family income" and "race/color" were statistically associated (p-value = 0.0001). Implementing the NTCP varies by location, and units with the highest success rates can be used as best practice examples to improve access and achieve smoking cessation goals across the municipality. Regional peculiarities and logistical obstacles impact the success of the PNAB and PNCT in the Amazon context.
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