Smoking cessation after hospitalization for myocardial infarction or cardiac surgery: Assessing patient interest, confidence, and physician prescribing practices

Abstract

Background Prioritizing and managing multiple behavior changes following a cardiac hospitalization can be difficult, particularly among smokers who must also overcome a serious addiction. Hypothesis Hospitalized smokers will report a strong interest in smoking cessation (SC) but will receive little assistance from their physicians. Methods We asked current smokers hospitalized for an acute cardiac event to prioritize their health behavior priorities, and inquired about their attitude toward SC therapies. We also assessed SC cessation prescriptions provided by their physicians. Results Of the 105 patients approached, 81 (77%) completed the survey. Of these, 72.5% ranked SC as their greatest health change priority, surpassing all other behavior changes, including: taking medications, attending cardiac rehabilitation (CR), dieting, losing weight, and attending doctor appointments. Patients felt that SCM (44%), CR (41%), and starting exercise (35%) would increase their likelihood for SC. While most patients agreed that smoking was harmful, 16% strongly disagreed that smoking was related to their hospitalization. At discharge, medication was prescribed to ~32% of patients, with equal frequency among patients who reported interest and those who reported no interest in using medications. Conclusion The majority of hospitalized smokers with cardiac disease want to quit smoking, desire help in doing so, and overwhelmingly rate cessation as their highest health behavior priority, although some believe smoking is unrelated to their disease. The period following an acute cardiac event appears to be a time of great receptivity to SC interventions; however, rates of providing tailored, evidence‐based interventions are disappointingly low.

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

“…Continued smoking following an MI is a significant driver of future mortality and morbidity (e.g. Boggon et al, 2014;Chow et al, 2010) and experiencing a major cardiac event, such as an MI, can be a driver of quit intentions and attempts (Riley et al, 2018(Riley et al, , 2019, but this experience may not be sufficient to promote successful sustained abstinence (Gaalema et al, 2018).…”

Manejo de la cesación tabáquica entre residentes de cardiología de Iberoamérica

“…Por otra parte, si bien los pacientes hospitalizados dejan de fumar voluntaria o involuntariamente (debido a políticas de hospitales libres de humo de tabaco), la mayoría vuelve a hacerlo después del alta 23 , 24 . Esto constituye una verdadera oportunidad perdida, ya que múltiples trabajos han demostrado que las personas que son hospitalizadas por un problema vinculado a la adicción del tabaco se encuentran más receptivas a la hora de recibir consejos para cesar su adicción 25 , 26 .…”

Smoking cessation after acute coronary syndrome: A systematic review and meta‐analysis

“…Consideration of these statistics may help persuade some young patients to quit smoking. In addition, the period of great receptivity for smoking cessation intervention is the period following an acute cardiac event and this is the time period where interventions should take place 68 . Although it has been reported that rate of providing tailored evidence‐based interventions is low, 68 this appears to be an approach that should be encouraged to foster long‐term smoking cessation.…”