Predictors of Quitting Smoking in Cardiac Rehabilitation

Salman, Ahmad; Doherty, Patrick

doi:10.3390/jcm9082612

Cited by 13 publications

(16 citation statements)

References 39 publications

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“…However, the strengths of our study include utilizing a prospective cohort design and an observational approach, and using data from a large-scale dataset that collects routine clinical information from CR programmes in the UK. This study also suggested that clinical and research efforts should be directed towards improving the rate of smoking cessation in patients with CVD by accounting for factors that predict quitting smoking among CR attendees [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Is Weight Gain Inevitable for Patients Trying to Quit Smoking as Part of Cardiac Rehabilitation?

Salman

Doherty

2020

IJERPH

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The literature is uncertain about the extent to which those who attend cardiac rehabilitation (CR) gain weight while trying to quit smoking. This study aimed to determine the extent of CR-based smoking cessation provision and whether CR, as delivered in routine practice, is associated with helping patients quit smoking and avoid weight gain. Data from the UK National Audit of Cardiac Rehabilitation database, between April 2013 and March 2016, were used. Smoking status is categorised as smokers and quitters assessed by patient self-report. Outcomes included body weight, blood pressure, depression, and physical activity. A multiple linear regression model was constructed to understand the effect of continuing smoking or quitting smoking on CR outcomes. CR outcome scores were adjusted by the baseline CR score for each characteristic. An e-survey collected information about the smoking cessation support offered to patients attending CR. A total of 2052 smokers (58.59 ± 10.49 years, 73.6% male) and 1238 quitters (57.63 ± 10.36 years, 75.8% male) were analysed. Overall, 92.6% of CR programmes in the United Kingdom (UK) offer smoking cessation support for CR attenders. Quitting smoking during CR was associated with a mean increase in body weight of 0.4 kg, which is much less than seen in systematic reviews. Quitters who attended CR also had better improvements in physical activity status and psychosocial health measures than smokers. As delivered in routine practice, CR programmes in the UK adhere to the guideline recommendations for smoking cessation interventions, help patients quit smoking, and avoid weight gain on completion of CR.

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Section: Discussionmentioning

confidence: 99%

Is Weight Gain Inevitable for Patients Trying to Quit Smoking as Part of Cardiac Rehabilitation?

Salman

Doherty

2020

IJERPH

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“…The copyright holder for this preprint this version posted January 11, 2023. ; https://doi.org/10.1101/2023.01.10.23284384 doi: medRxiv preprint or living with a partner 24 . However, a study of patients in care for cardiac rehabilitation found higher odds of quitting success for people who were married vs. single 34 . In the UK general population, studies reported finding no relationship between quitting success and marital status, 29 cohabitation status, 38 or number of household smokers.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…The copyright holder for this preprint this version posted January 11, 2023. ; https://doi.org/10.1101/2023.01.10.23284384 doi: medRxiv preprint abuse and marijuana abuse vs. no history of substance abuse. 41 No relationship with quitting success was reported in three studies that investigated primary mental health diagnosis, 31 35 41 two studies of PHQ-9 score, 31 42 one study of having a history of substance abuse, 31 one study of HADS anxiety score and HADS depression score, 34 and one study of history of psychiatric disorder and history of co-occurring substance use and psychiatric disorder. 33…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…One study in an outpatient setting reported higher odds of quitting success for patients with low (vs. moderate or high) cardiovascular risk and patients with fewer comorbidities. 34 However, no relationship was found between quitting success and moderate (vs. high) cardiovascular risk. 34 Another study found no relationship between quitting success and the number of comorbidities that a patient had.…”

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Covariates of success in quitting smoking in the community and secondary acute or mental health care services: a rapid systematic review

Everson-Hock

Franklin

Baxter

et al. 2023

Preprint

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Introduction Tobacco smokers contacting secondary healthcare services in the United Kingdom (UK) are increasingly being offered support to quit smoking, but there are person and setting-related variables that could moderate their success in quitting smoking. This rapid literature review aims to identify a comprehensive set of variables associated with quitting success. Methods Systematic searches of five electronic databases identified published studies that investigated the success of attempts to quit smoking. Studies eligible for inclusion investigated quitting success in one of three contexts: (a) the general population in the UK; (b) people with a mental health condition; (c) quit attempts initiated within a secondary care setting. Data related to the statistical analysis for all covariates of quitting success were extracted from included papers, then synthesised to identify covariates with a statistically significant (i.e., p-value <0.05) association. Results The review identified 29 relevant studies and 14 data fields, which we grouped into four categories: demographics (age; sex; ethnicity; socio-economic conditions; relationship status, cohabitation and social network), individual health status and healthcare setting (physical health, mental health), tobacco smoking variables (current tobacco consumption, smoking history, nicotine dependence; motivation to quit; quitting history), and intervention characteristics (reduction in amount smoked prior to quitting, the nature of behavioural support, tobacco dependence treatment duration, pharmacological aids). Conclusions Fourteen data fields were identified as having a statistically significant relationship with smoking quit success. These data fields should be considered for inclusion in datasets and statistical analysis plans for evaluating the quitting outcomes of smoking cessation interventions initiated in secondary care contexts in the UK.

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“…However, most CR programs rely, solely, on self-report measures when assessing smoking status (e.g., Salman & Doherty, 2020). Self-reported smoking, however, likely does not capture all of the patients who are currently smoking.…”

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confidence: 99%

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

Gaalema¹,

Yant²,

Khadanga³

et al. 2022

Health Psychology

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Objective: Participation in cardiac rehabilitation (CR) is associated with reduced morbidity and mortality. However, most programs rely on self-report measures when assessing the critical risk factor of smoking. This study examined smoking status using self-report versus objective measurement using expired carbon monoxide (CO) and compared patient characteristics by CO level. Method: Patients were screened for smoking status when entering CR by self-report and by objectively measured CO. Measures of aerobic fitness, educational attainment, depressive symptoms, and self-reported physical function were also collected. The discrepancy between smoking status based on self-report and objective measurement was examined and patient characteristics by CO measurement were compared. Results: Of the 853 patients screened, 62 self-reported current smoking and 112 had a CO of ≥4 ppm. Using a cut-off of ≥4 ppm encompassed almost all self-reported smokers (specificity: 98.5%) and identified 61 patients (not reporting current smoking) needing further screening. Further questioning yielded an additional 21 patients with combusted use (tobacco/cannabis), six nonsmoking patients with environmental CO exposure, and 34 where the reason for elevated CO was unknown. CO ≥4 ppm patients were younger (62.2 vs. 67.7, p < .01), had higher depression scores (5.6 vs. 3.7, Patient Health Questionairre-9, p < .01), had lower educational attainment (59.0% ≤high school vs. 31.3%, p < .01), had lower levels of fitness (after controlling for clinical characteristics, p < .01), and completed fewer CR sessions (18 vs. 22, p < .01). Conclusions: A substantial number of patients who are actively smoking may be misclassified by relying on patient report alone. CO monitoring provides a simple and objective method of systematically screening patients.

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Predictors of Quitting Smoking in Cardiac Rehabilitation

Cited by 13 publications

References 39 publications

Is Weight Gain Inevitable for Patients Trying to Quit Smoking as Part of Cardiac Rehabilitation?

Is Weight Gain Inevitable for Patients Trying to Quit Smoking as Part of Cardiac Rehabilitation?

Covariates of success in quitting smoking in the community and secondary acute or mental health care services: a rapid systematic review

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

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