Valued Life Activities, Smoking Cessation, and Mood in Post-Acute Coronary Syndrome Patients

Abstract

Purpose Continued engagement in valued life activities is a protective factor for depression and has been linked to readiness to quit smoking in medical populations, but has never been examined among Acute Coronary Syndrome (ACS) patients. The purpose of this study is to investigate relationships among valued life activities, mood, and smoking post-ACS. Methods Participants were 54 post-ACS patients who were smoking before ACS hospitalization. Data on mood, smoking status, engagement in valued activities, restriction of valued activities, and satisfactory replacement of restricted activities was collected 1-12 months post-ACS. Results Depressive symptoms were associated with both less valued activity engagement and greater valued activity restriction. Positive affect was associated with greater valued activity engagement and negative affect was associated with greater valued activity restriction. Satisfactory replacement of restricted activities was associated with greater positive affect, fewer depressive symptoms, and quitting smoking post-ACS. The majority of these relationships remained significant after controlling for relevant covariates, including physical functioning. Conclusions Valued activity restriction and engagement may contribute to depressed mood and failure to quit smoking in ACS patients. Psychotherapies that target greater engagement in valued life activities deserve further investigation in ACS patients.

Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial

“…Our adaptation of this existing manual was required to account for treatment setting (e.g., initiation while hospitalized) and structure (i.e., fewer, shorter, individual counseling sessions, mostly over the phone) to better fit the needs and preferences of post-ACS patients. We assessed needs and preferences of post-ACS smokers through extensive mixed method interviews [ 28 ] and test cases. Adaptation was also guided by clear meta-analytic data on the dose of treatment needed for significant effects on smoking cessation in hospitalized cardiac patients [ 29 , 30 ].…”

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