Current smoking as a marker of a high-risk behavioral profile after myocardial infarction

Carbon monoxide monitoring to objectively measure smoking status in cardiac rehabilitation.

“…Those in the CO ≥4 ppm group had higher levels of depressive symptoms, lower levels of educational attainment, attended fewer sessions of CR and, despite being younger, have similar fitness levels as the CO <4 ppm group. This is consistent with existing national level data where patients who smoke develop cardiovascular disease at a younger age, report more issues with mental health, and report lower levels of physical activity than both former and never smokers (Gaalema et al, 2020). Smoking status itself is, of course, also important.…”

“…Additionally, objective screening can help to more accurately calculate the proportion of CR patients who are currently smoking. While those that smoke may be less likely to attend CR (Gaalema et al, 2020) it may also be the case that those who smoke are not always reporting it during CR, causing the number of current smokers in CR to appear lower than it actually is.…”

“…Identifying those who smoke is also important, as those who smoke are at high risk for other reasons as well. Those with cardiovascular disease who smoke tend to be younger, have lower levels of socioeconomic status, higher levels of depressive symptoms, and are more likely to engage in other health-related behaviors that increase their risk after a cardiac event (Gaalema et al, 2018(Gaalema et al, , 2020. Additionally, those who smoke are more likely to drop out of CR (Gaalema et al, 2015(Gaalema et al, , 2017.…”

The Association of Patient Educational Attainment With Cardiac Rehabilitation Adherence and Health Outcomes

“…Of these individual factors, educational attainment appears to be a particularly strong predictor of health-related behaviors and health outcomes, a pattern that is also seen specifically within risk for MI 10. Speaking of SES more broadly, patients of lower SES have a higher prevalence of behavioral risk factors for coronary artery disease (CAD) such as smoking 11. Additionally, they tend to exercise less and make fewer needed behavioral changes after an MI,12,13 which corresponds to overall poorer health, greater cardiac risk severity, and an increased rate of mortality after MI 14–16.…”

Objective measure of smoking status highlights disparities by sex

“…Cigarette smoking is the leading cause of preventable death, and the prevalence of smoking is higher among those with cardiovascular disease (CVD) compared to the general population [ 1 – 3 ]. Smoking is a major contributor to the premature development of CVD.…”