Effects of Motivational Interview and Mobile Social Network Support on Smoking Cessation in Male Patients With Coronary Heart Disease

Abstract

Patients with coronary heart disease (CHD) who quit smoking exhibit lower rates of heart attack recurrence and mortality than their peers who continue smoking. However, most male patients with CHD resume smoking after hospital discharge. To explore the effectiveness of motivational interventions and mobile social network support on smoking cessation and other predictors of smoking cessation in male patients with CHD. An experimental design was used, and a convenience sample was recruited from a cardiology ward of a hospital in northern Taiwan. The participants were randomly assigned to the experimental group (n = 57) and control group (n = 64). During hospitalization, each participant completed a questionnaire after undergoing cardiac catheterization. The questionnaire included a demographic datasheet, the Fagerström Test for Nicotine Dependence, and the contemplation ladder. Afterward, the experimental group received motivational interventions, filled out a self-efficacy scale and the contemplation ladder, and joined an online mobile social group (LINE) for three months. The control group received regular care and a smoking cessation booklet, and then filled out the self-efficacy scale and contemplation ladder. An intention-to-treat analysis was adopted to evaluate smoke cessation status. Information on post-discharge smoking status was collected from the participants via the Line communications app or phone calls at three-months after hospital discharge and was further confirmed using urinary cotinine levels. The results revealed that both groups registered improvements in motivation to quit smoking. This motivation was relatively higher in the experimental group after the intervention than in the control group. The smoking cessation rate in the experimental group (35.09%) was higher than that in the control group (17.19%). However, the intergroup difference in the cessation rate only approached statistical significance (OR: 2.34; p = .055) after controlling for the baseline difference between the two groups. Controlling for the effects of the intervention, age of smoking initiation, first diagnosis of CHD, and self-efficacy were identified as predictors of smoking cessation. Healthcare providers are encouraged to provide motivational interviews to enhance the motivation of their patients to quit smoking as well as to incorporate self-efficacy into related interventions to increase the smoking cessation rate.