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Smoking cessation initiated during hospital stay for patients with coronary artery disease: a randomized controlled trial

From the Human Science Division, Northern Ontario School of Medicine (Smith); and the Department of Medicine (Burgess), University of Calgary, Calgary, Alta.

Correspondence to: Dr. Patricia Smith, Northern Ontario School of Medicine, 955 Oliver Rd., Thunder Bay ON P7B 5E1; fax 807 766-7362; patricia.smith{at}normed.ca

Background: Programs for smoking cessation for cardiac patients are underused in Canada. We examined the efficacy of an intervention for smoking cessation for patients admitted to hospital for coronary artery bypass graft (CABG) or because of acute myocardial infarction (MI).

Methods: Nurses randomly assigned 276 sequential patients admitted because of acute MI or for CABG who met the inclusion criteria. Participants received an intensive or minimal smoking-cessation intervention. The minimal intervention included advice from physicians and nurses and 2 pamphlets. The intensive intervention included the minimal intervention plus 60 minutes of bedside counselling, take-home materials and 7 nurse-initiated counselling calls for 2 months after discharge. The outcomes were point prevalence of abstinence at 3, 6 and 12 months after discharge.

Results: The 12-month self-reported rate of abstinence was 62% among patients in the intensive group and 46% among those in the minimal group (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2–3.1). Abstinence was confirmed for 54% of patients in the intensive group and 35% in the minimal group (OR 2.0, 95% CI 1.3–3.6). Abstinence was significantly lower among those who used pharmacotherapy than among those who did not (p < 0.001). Continuous 12-month abstinence was 57% in the intensive group and 39% in the minimal group (p < 0.01). It was significantly higher among patients admitted for CABG than among those admitted because of acute MI (p < 0.05).

Interpretation: Providing intensive programs for smoking cessation for patients admitted for CABG or because of acute MI could have a major impact on health and health care costs.

This article has been cited by other articles:

				Smoking Cessation in the CCU Journal Watch (General), July 28, 2009; 2009(728): 4 - 4. [Full Text]

				Smoking Cessation: How Much Evidence Do We Need to Act? Journal Watch Cardiology, July 22, 2009; 2009(722): 1 - 1. [Full Text]

				N. A. Rigotti Helping smokers with cardiac disease to abstain from tobacco after a stay in hospital Can. Med. Assoc. J., June 23, 2009; 180(13): 1283 - 1284. [Full Text] [PDF]

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