Abstract
BackgroundWithout assistance, smokers being admitted to the hospital for coronary heart disease often return to regular smoking within a year.ObjectiveThis study assessed the 12-month effectiveness of a telephone and a face-to-face counselling intervention on smoking abstinence among cardiac patients. Differential effects for subgroups varying in their socioeconomic status and intention to quit smoking were also studied.MethodsA randomised controlled trial was used. During hospital stay, smokers hospitalised for coronary heart disease were assigned to usual care (n = 245), telephone counselling (n = 223) or face-to-face counselling (n = 157). Eligible patients were allocated to an intervention counselling group and received nicotine patches. After 12 months, self-reported continued abstinence was assessed and biochemically verified in quitters. Effects on smoking abstinence were tested using multilevel logistic regression analyses applying the intention-to-treat approach.ResultsCompared with usual care, differential effects of telephone and face-to-face counselling on continued abstinence were found in patients with a low socioeconomic status and in patients with a low quit intention. For these patients, telephone counselling increased the likelihood of abstinence threefold (OR = 3.10, 95 % CI 1.32–7.31, p = 0.01), whereas face-to-face counselling increased this likelihood fivefold (OR = 5.30, 95 % CI 2.13–13.17, p < 0.001). Considering the total sample, the interventions did not result in stronger effects than usual care.ConclusionPost-discharge telephone and face-to-face counselling interventions increased smoking abstinence rates at 12 months compared with usual care among cardiac patients of low socioeconomic status and low quit intentions. The present study indicates that patients of high socioeconomic status and high quit motivation require different cessation approaches.
Highlights
Without assistance, smokers being admitted to the hospital for coronary heart disease often return to regular smoking within a year
There were trends that patients were more likely to be lost to followup when they had previously been admitted to the hospital (OR = 1.62, 95 % CI 1.00–2.61, p = 0.05) and when they had made one or more attempts to quit in the past (OR = 1.51, 95 % CI 0.98–2.33, p = 0.06)
Despite efforts in optimising smoking cessation programs, the overall percentage of continued smoking abstinence is still disappointing in the Netherlands [4] and remains an ongoing challenge
Summary
Smokers being admitted to the hospital for coronary heart disease often return to regular smoking within a year. Studies have estimated up to 40 % reduced risks of recurrent coronary events and subsequent mortality in patients who quit smoking after a coronary event [1], one out of two patients still persist in smoking or relapse after hospital discharge [2,3,4]. Behavioural interventions initiated during hospital admission with regular follow-up contacts. Cross-over randomisaƟon at the ward level (n = 625). PaƟents allocated to usual care (n = 245). PaƟents allocated to telephone counselling + NRT (n = 223). PaƟents allocated to faceto-face counselling + NRT (n = 157).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
