Patients Stop Smoking Research Articles

Abstract 2152: Evaluating beliefs and perceived competence about tobacco cancer prevention practices in Texas local mental health authorities

Abstract Tobacco use is causally associated with 18 cancers and is a leading cause of preventable death. Individuals experiencing mental illness use tobacco at an elevated rate and consequently suffer from greater cancer-related morbidity and mortality. Unfortunately, local mental health authorities (LMHAs), a common setting to receive mental health services, do not prioritize tobacco dependence treatment despite robust evidence that tobacco cessation can enhance mental health in addition to reducing cancer incidence. Beliefs (Health Belief Model) and competence (Self Determination Theory) both play an integral role in shaping behavior. Consequently, this study examined employee and provider tobacco-related beliefs and competence in LMHAs to contextualize their tobacco intervention practices. The frequency of beliefs and competence related to provision of evidence-based tobacco cessation care was collected by e-survey from organizational representatives of 30 of the 39 LMHAs in Texas in 2021. Queries included if respondents agreed that patients should concurrently quit drugs/alcohol and tobacco (N=30 employees) and if they believed patients want to quit cigarette and non-cigarette (i.e., other) tobacco products (n=16 direct service providers). Providers were also asked if they thought that they had the competence to help patients quit smoking and other tobacco use, if they could tailor cessation treatment to patient needs, and about their intervention practices. Only 40% of LMHA representatives endorsed that patients should quit tobacco at the same time as other drugs. Furthermore, only 50% of providers believed that patients want to quit smoking and other tobacco use, respectively. About 70% of providers believed that they have the skills to help patients quit smoking and other tobacco use, respectively, but only 56% reported that they can tailor treatment. Finally, only 56% and 38% of providers recommend that patients stop smoking or other tobacco use, respectively, with 25% recommending smokers switch to vapes or smokeless tobacco products. Contrary to LMHA employee and provider beliefs, research indicates that most patients want to quit tobacco use and that concurrent tobacco use treatment can enhance patient sobriety for non-nicotine substance use disorders. Results demonstrate high levels of misinformation on concurrent tobacco and substance use treatment in LMHAs, which can subvert the provision of evidence-based cessation care. Educational interventions are needed to shift these beliefs, increase competence, and increase tobacco use intervention provision. This will not only help to address cancer disparities among patients but also improve mental health- a critical goal of LMHAs. Future research should investigate how to target tobacco-related beliefs, competence, and intervention behavior in LMHAs to broaden the reach of cancer prevention strategies. Citation Format: Ammar D. Siddiqi, Maggie Britton, Tzuan A. Chen, Isabel Martinez Leal, Anastasia Rogova, Midhat Z. Jafry, Bryce Kyburz, Teresa Williams, Lorraine R. Reitzel. Evaluating beliefs and perceived competence about tobacco cancer prevention practices in Texas local mental health authorities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2152.

How to Effectively Help Patients Stop Smoking: A Primer for Cardiologists.

Tobacco smoking is a chronic disorder based on nicotine dependence and is the single most reversible risk factor of cardiovascular diseases.1 This primer provides an overview of evidence-based smoking cessation interventions, pharmacological and nonpharmacological. Interventions with limited or conflicting data are also discussed. These recommendations are intended for clinicians (physicians and nonphysicians) because smoking cessation services is a fundamental responsibility for health care providers in all settings.

Early Diagnosis of Kidney Damage Associated with Tobacco Use: Preventive Application.

Although long-term smoking has been associated with chronic kidney disease, its effect on kidney function in early stages has not been clarified. Therefore, the proposed objectives were: (1) to identify subclinical kidney damage in smokers, through a panel of biomarkers; (2) to evaluate the progression of subclinical kidney damage after two years of consumption in these patients; and (3) study whether quitting smoking reduces kidney damage. A prospective study was carried out (patients recruited from a primary care centre and a clinical smoking unit). Kidney function was assessed using a panel of biomarkers and compared between smokers and non-smokers, taking into account potential risk factors for kidney damage. These results show, for the first time in the literature, the relationship between smoking and early (subclinical) kidney damage and provide a panel of biomarkers capable of detecting this condition (Neutrophil gelatinase-associated lipocalin, Kidney injury molecule-1, N-acetyl-beta-D-glucosaminidase, transferrin, and ganglioside-activating protein GM2). This study also indicates that subclinical damage is maintained when use continues, but can be reversed if patients stop smoking. The use of these biomarkers as diagnostic tools can be a preventive measure in the development of chronic kidney disease associated with smoking and in the prevention of acute events associated with potentially nephrotoxic pharmacological treatment in smokers. Trial registration number: NCT03850756.

Les conséquences du confinement sur les maladies cardiovasculaires

BackgroundThe Sars COV-2 infection causing the covid-19 disease has started in December 2019 inWuhan, China, then spread quickly to more than 100 countries in less than 3 months. On March, 11th the WHO declared officially the pandemic of Covid 19. In the absence of an effective treatment of the SARS-Cov2 the measures of social distancing and lockdown remain the most effectives ways against the pandemic. However, these measures can have repercussions in particular on patients followed for chronic diseases, the goal of our study will be to evaluate the impact of the lockdown on non-Covid cardiac patients. MethodsWe have chosen a random sample of patients followed in the cardiology department of the CHU Tangier Tetouan Alhouceima, and we collected their demographic data as well as the symptoms, vital constants, lifestyle before and 60 days after the lockdown. ResultsA total of 100 patients were included in the study. The average age of our population is 55.34 years±15.86. The average BMI (body mass index) is 26.40 Kg/m2±5.84. The coronary artery disease was present in 27% of the patients, valvular disease in 40% and heart failure in 37%. Finally, arrhythmias appear in 22% and more than the half of our sample has high blood pressure. We noted a significant weight gain of 1.71 Kg (P<0.000) after 60 days of lockdown, with an increase of BMI of 0,58 kg/m2 (P<0,005). The percentage of patients with SBP (systolic blood pressure) ≥140mmHg has evolved from 38 to 44%, thus an increase of 6 % (P<0,0001), while the percentage of the patients with DBP (diastolic blood pressure) ≥90mmHg has passed from 21 to 15 % (thus a decrease of 6 %, P<0,0001). Twenty patients stop smoking, thus a decrease of 7% (P<0,0001). The sedentary lifestyle rate presented an elevation of 22% (P<0,0001). The daily calorie intake has increased of 35,4 % and 46,8 % of the patients increased their salt intake by more than 4 g per day. The increase of the daily calorie intake concerned more the men than the women (41,9 % of men vs 31,3 % of the women). In the population with high blood pressure, we have not observed a statistically significant difference of the SBP, the DBP and the heart rate between the beginning and two months after the lockdown. Concerning patients with heart Failure, we have noted an worsen of the symptoms of HF. Thus, 8,1% of the patients presenting a stage two dyspnea has passed to a stage three of the NYHA (32,4 vs 40,5%), while the percentage of patients with lower limbs edema has increased of 13,5% but in a non-statistically significant way (P=0,267). We have noticed a diet gap with an increase of salt intakes (more than 4g per day) in more than the half of this subpopulation (55,6 %) during the period of the lockdown. In the subpopulation of patients with valvular pathology, we have identified a worsening of the dyspnea in 7,5% of the patients; this one has passed from stage two to stage three of the NHYA with an increase of the percentage of patients with lower limbs edema from 7,5% to 25% (P=0,065). Furthermore, we have noticed an incidence of 10% of cardiovascular events (2 cases of myocardial infarction [among which one has deceased], one death because of end stage heart failure, three hospitalizations for congestive heart failure, two cases of aortic dissections and 2 cases of rapid atrial fibrillation). Our observationDepending on the results of this study, the sanitary lockdown induced important repercussions on the patients followed for cardiac diseases, hence the necessity of an awareness of these patients, and mostly a restructuring of our care system strongly disturbed by the Covid 19.

¿Mienten los pacientes con EPOC sobre su hábito tabáquico?

ObjetivoDeterminar la tasa de decepción o concordancia entre la respuesta de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) sobre su hábito tabáquico y la medición del mismo por cooximetría en una consulta monográfica EPOC.DiseñoEstudio observacional prospectivo para determinar la concordancia entre los valores de cooximetría y la respuesta a entrevista clínica sobre hábito tabáquico.EmplazamientoConsulta monográfica de EPOC, Neumología, Sevilla.ParticipantesPacientes con diagnóstico confirmado de EPOC en cualquier grado.IntervencionesEntrevista clínica y medición de monóxido de carbono mediante cooximetría.Mediciones principalesValores de cooximetría, respuestas sobre hábito tabáquico, variables sociodemográficas.ResultadosSe incluyó un total de 169 pacientes (n: 169) de los cuales, 107 presentaron valores menores o iguales 6 ppm frente a 62 con valores mayores a 6 ppm, determinando una prevalencia de tabaquismo activo del 36,7%.La tasa de decepción fue del 19,5% del total de la muestra (24,3% de entre todos los que afirmaban no fumar), con una kappa de Cohen de 0,48 y p < 0,000. El 40% de los pacientes confesó no haber dicho la verdad.No se encontró ninguna relación de este dato con la edad, el consumo acumulado de tabaco ni el FEV1. Se halló una relación significativa con el sexo (tasa de decepción: 31,8% en las mujeres vs. 15,2% en los hombres, p 0,017).ConclusionesA pesar de nuestros intentos para que los pacientes dejen de fumar, la tasa de decepción en nuestra consulta fue considerable, mayor entre las mujeres, exfumadores recientes o en proceso de abandono, por lo que sería fundamental incorporar medidas objetivas como el cooxímetro en el abordaje de este tipo de pacientes.

Long-term effects of smoking cessation support in primary care: results of a two-year longitudinal study in Brazil

ABSTRACT Objective The objective of this study was to evaluate the long-term effects of a Brazilian smoking cessation support program and the factors that are associated with its success. Methods A longitudinal study was conducted from 2012 to 2014 with 84 patients enrolled in smoking cessation support groups in a Primary Care Center from a poor community in Rio de Janeiro (Brazil). Support was provided according to Brazilian Tobacco Control Program and consisted of cognitive behavioral therapy in addition to nicotine replacement therapy. Logistic regression and the Cox proportional hazard models were used in the analysis. Results There was an increase of 34%, 48% and 97% in the chances of patients stop smoking for at least six months, 12 months and 24 months, respectively, for each new session that the patient participated. Patients that attended three or more meetings had a 79% lower risk of returning to smoking than those who went to less than three meetings. Conclusions Although not all patients who were enrolled in the program could be contacted for the study, our results indicate that about 40% of patients are able to stay smoke-free for at least three months due to the smoking cessation program, but less than 20% are able to remain smoke-free for two years. Initiatives to improve adherence to cognitive behavioral therapy meetings according to the specificity of the population may increase the effectiveness of the program.

Can E-Cigarettes Cause Free Flap Failure? A Case of Arterial Vasospasm Induced by Electronic Cigarettes Following Microsurgical Breast Reconstruction.

Sir: The vasoconstrictive effects of cigarettes is well documented and routinely discussed with patients seeking microsurgical breast reconstruction. It is generally accepted that patients stop smoking 2–4 weeks before the planned reconstruction to avoid vasoconstriction and to prevent issues with wound healing. Although studies have documented the consequences of cigarette smoking on flap failure and wound healing, no prior study has documented the potential consequence of free flap failure after the use of electronic cigarettes (e-cigarette).1 A 48-year-old woman with right intraductal carcinoma was presented in May 2015 for delayed autologous breast reconstruction. She is a former cigarette smoker who confirmed that she had stopped smoking before scheduling surgery. The patient underwent a bilateral muscle-sparing free transverse rectus abdominis musculocutaneous flap reconstruction without any intraoperative complications. The following morning, the Vioptix Tissue Oximeter (Fremont, Ca) reading on the left breast dropped to 35% with deteriorating clinical examination. Bedside evaluation 20 minutes later revealed a clinically healthy appearing flap with a 77% Vioptix signal (Fig. 1). Transient vasospasm was suspected. On postoperative day 2, the Vioptix reading on the left breast dropped to 3% with progressive flap deterioration. The decision was made to return to the operating room for an exploration. During transport to the operating room, the Vioptix reading returned to baseline; however, the decision to explore the anastomosis was maintained. Exploration revealed widely patient arterial and venous anastomoses without any kinks or twists of the pedicle. Nifedipine (10 mg per os daily) was started for presumed vasospasm. The patient then had an uneventful hospital course and was discharged home on postoperative day 4. It was later revealed to the plastic surgery team by the patient’s mother that the patient had been smoking e-cigarettes until the day of surgery.Fig. 1: Photograph of the patient and corresponding Vioptix readings (left flap is top reading, right flap is bottom reading) when initially called to see patient by nursing staff after a drop in the Vioptix reading to 35% on the left side. Upon examining the patient, her left flap appeared clinically healthy and the Vioptix reading rebounded to 77% spontaneously.E-cigarettes are battery-powered, vaporized nicotine delivery devices introduced into the U.S. in 2007 as a safe alternative to traditional tobacco-based cigarette smoking.2 The use of e-cigarettes has increased in popularity to more than 6% of the population in the U.S. with nearly one third of current smokers reporting to have ever used e-cigarettes.3 E-cigarettes are unregulated by the U.S. Food and Drug Administration and can be bought over the counter or online with no limit on the nicotine content. The vascular consequences of smoking traditional cigarettes/cigars are widely published and routinely counseled to patients; however, few providers discuss the use of e-cigarettes. Although e-cigarettes are free from many of the carbon monoxide, carcinogens, and tobacco present in traditional cigarettes/cigars, they contain variable amounts of nicotine that can cause peripheral vasoconstriction and inhibition of endothelial-dependent vasodilation, which can have devastating effects on free flaps.4 There are few publications about the consequences of e-cigarettes in the plastic surgery literature.5 This case example will help surgeons to advise patients on the risks of all tobacco products including e-cigarettes during the preoperative workup. DISCLOSURES M.Y.N. is a consultant for LifeCell. The other authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by Dr. Nahabedian. PATIENT CONSENT Patient provided consent for the use of her images and there are no patient identifiers in the images used.

Duration of Smoking Cessation and Postoperative Morbidity After Esophagectomy for Esophageal Cancer: How Long Should Patients Stop Smoking Before Surgery?

Smoking is one of the risk factors for postoperative morbidity. There were no studies on the correlation between the duration of smoking cessation and the incidence of morbidities after esophagectomy. A total of 246 patients undergoing elective esophagectomy with 2- or 3-field lymphadenectomy for esophageal cancer between April 2005 and February 2015 were retrospectively analyzed. Patients were divided into five groups according to the duration of smoking cessation [no smoking cessation (including cessation for a few days), cessation for 7-30, 31-90, ≥91 days, never smoker]. Any morbidity of Clavien-Dindo classification (CDc) ≥II, pneumonia, any pulmonary morbidity, surgical site infection, cardiovascular morbidity, and severe morbidities of CDc ≥IIIb frequently occurred in patients with no smoking cessation. The incidence of pneumonia and severe morbidities decreased as the duration of smoking cessation became longer. Logistic regression analysis suggested that no smoking cessation was the independent risk factor for any pulmonary morbidity (HR 3.68, 95% CI 1.152-11.74; p = 0.028). Smoking cessation ≤30 days was also the independent risk factor for pneumonia (HR 2.89, 95% CI 1.141-7.301; p = 0.025). Smoking cessation ≤90 days was the independent risk factor for severe morbidities of CDc ≥IIIb (HR 2.82, 95% CI 1.072-7.427; p = 0.036). Preoperative smoking cessation more than 90 days is ideal to reduce morbidities after esophagectomy. When patients with insufficient smoking cessation undergo esophagectomy, careful perioperative management is required.

Searching for More Effective Smoking Cessation Treatment

Searching for More Effective Smoking Cessation Treatment

Smoker’s Boils

Background: About 90% of patients with hidradenitis suppurativa (HS) are smokers. A crucial eliciting role of smoking appears to be certain. In order to increase the awareness of this avoidable major cause of the disease and to facilitate the recognition of incipient disorder, we propose the more specific term ‘smoker’s boils’ for HS lesions of patients who are smokers. Method: Clinical pictures of early lesions are presented. For the exceptional cases occurring in nonsmokers, the traditional name HS, representing an umbrella term, is adequate. Result/Conclusion: The renaming of HS as smoker’s boils has the practical advantage that a correct diagnosis can be made at an incipient stage of the disorder. If patients stop smoking at such an early stage of HS, they most likely have a chance that this devastating disease will not progress.

Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Anal cancer is strongly associated with human papilloma virus (HPV) infection. Using polymerase chain reaction (PCR), the presence of the HPV genome has been identified in 80%–85% of cases. Other important risk factors include human immunodeficiency virus (HIV), immune suppression in transplant recipients and cigarette smoking. Herpes simplex virus (HSV)may play a secondary role in disease progression.Dietaryhabits, chronic inflammatory diseases and the presence of haemorrhoids do not appear to predispose to epidermoid anal cancer. Previous (gynaecological, lymphoma or leukemia) or subsequent (e.g. lung, bladder, vulva, vagina or breast) malignancy is more likely in anal cancer patients. This observation may reflect a genetic predisposition in some individuals, while in others synchronous or metachronous multicentric epidermoid tumours are related to HPV infection. pathology and biology

The Importance of Tobacco Cessation Training for Nurses in Serbia

This study assessed smoking prevalence, attitudes, and perceived patient counseling responsibilities among practicing nurses in Serbia. The need for nurses to receive tobacco cessation training is explored. Data were collected through a cross-sectional survey of 230 nurses at public institutions in Belgrade, a health care center in Belgrade, and public health care facilities throughout Serbia. The smoking prevalence was 52% for male nurses and 47% for female nurses. Nurses had the greatest mean level of agreement with statements about controlling smoking through policy, followed by statements about being role models. Only 15% (n = 35) of nurses regularly counseled their patients about smoking, and only 16% of nurses (45% of males vs. 12% of females, p < .0001) had received training in counseling patients about smoking. Nurses' training in counseling patients about smoking was positively associated with the nurses' belief that their counseling could help patients stop smoking or never start smoking. In addition, nurses with training in counseling patients about smoking considered themselves significantly better prepared to assist patients to quit smoking. Nurses who smoked were significantly less likely to believe that their counseling about smoking could be effective. They also felt significantly less well prepared to assist patients to quit smoking. These findings show that nurses' training in tobacco cessation counseling results in greater self-perceived confidence and frequency of regular tobacco cessation counseling in Serbia.

Smoking patterns in patients following a pulmonary embolism

To the Editors: Tobacco smoking is a major risk factor for cardiovascular disease. It has been found that 30–40% of patients stop smoking spontaneously after the occurrence of serious cardiovascular events 1. Pulmonary embolism is a potential lethal cardiovascular event, in which smoking behaviour has not yet been documented. Since patients surviving the acute embolus face an increased risk of arterial thrombotic events, i.e. myocardial infarction and stroke 2–4, the propensity to quit smoking following pulmonary embolism is of particular interest. Our objective was to determine the impact of an episode of pulmonary embolism on smoking behaviour. We compared the fraction of smokers and the percentage of successful smoking cessation in pulmonary embolism patients with those in population-based controls. Data from a large follow-up project of patients with pulmonary embolism were used for the analysis. …

Self-reported smoking cessation activities among Swiss primary care physicians

BackgroundIndividual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking.MethodsThe survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as ≥ 2.ResultsThe response rate was 55%. Respondents were predominately over the age of 40 years (88%), male (79%), and resided in urban areas (74%). Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%), bupropion (65%), or provided counselling (70%). A minority of physicians recommended acupuncture (26%), hypnosis (8%), relaxation (7%), or self-help material (24%). A good practice score was obtained by 85% of respondents. Having attended a smoking cessation-training program was the only significant predictor of a good practice score (odds ratio: 6.24, 95% CI 1.95–20.04).ConclusionThe majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit.

Addressing Smoking in Community Drug Abuse Treatment Programs: Practical and Policy Considerations

Smoking is the leading cause of preventable death in the United States. This public health problem is of particular concern among individuals with substance use disorders in that they smoke at a greater rate than the general public. Smoking-related illness represents a major source of preventable death in persons with drug dependencies. Substance abuse treatment programs have access to persons with substance use disorders and the opportunity to intervene on their smoking; however, nicotine dependence has historically not been viewed in the same light as other drug dependencies by the treatment field. As a result, many persons in these treatment program settings do not receive opportunities to address their smoking. When substance abuse treatment organizations consider implementing smoking policies and services, many questions and choices arise. In practice, a range of approaches has been developed from simple assessment and referral for smoking cessation treatment to implementing smoke-free grounds and requiring that patients stop smoking concurrent with addressing their other drug dependencies. Smoking cessation policy decisions have the potential to directly affect the patients. the workforce, the referral network, and other major stakeholders related to these organizations. The authors consider a range of both practical and policy issues facing treatment organizations and conclude that advances in smoking policy are possible with current resources.

Pagalba metantiems rūkyti ir medikamentinis priklausomybės nuo tabako gydymas

Priklausomybė nuo tabako yra lėtinė atsinaujinanti liga, kurią įveikti be pagalbos pajėgia tik maža dalis rūkalių, absoliučiai daugumai reikalingas gydymas. Pagalba metantiems rūkyti – vienas iš veiksmingiausių būdų, leidžiančių sumažinti mirčių nuo tabako sukeltų ligų. Kiekvienas gydytojas, nesugaišęs daug laiko, gali padėti rūkantiems pacientams pagal minimalaus poveikio principus. Įrodyta, kad vien gydytojo patarimas padidina metimo rūkyti sėkmės tikimybę. Tinkamai atlikus diagnostiką, pacientams gali būti taikomas medikamentinis priklausomybės nuo tabako gydymas. Vaistinių preparatų pirmiausia tiktų skirti pacientams, turintiems stiprią fizinę priklausomybę nuo nikotino. Nikotinas, pats savaime psichiką veikianti ir priklausomybę sukelianti medžiaga, gali būti sėkmingai naudojamas priklausomybei nuo tabako gydyti. Kartu su pakeičiamuoju gydymu nikotino produktais arba atskirai gali būti skiriama vartoti bupropiono.

Tabagisme en période périopératoire

Smokers have an elevated risk of perioperative respiratory distress and of transfer to intensive care. Tobacco smoke substantially alters the healing process and constitutes a documented risk factor for postoperative complications (anastomotic leakage, delayed healing etc.). Risk of postoperative infection is also higher in smokers. When patients stop smoking 6 to 8 weeks before surgery, the incidence of complications related to tobacco smoke drops nearly to zero. Even stopping for a short period reduces the risk of complications, although the benefits of stopping increase with length of time. Preoperative smoking cessation should take place as early as possible. The general practitioner and the surgeon both have essential roles to play. Identification of smokers must be accompanied by measures to help the patient stop smoking, including advice, and if necessary, nicotine substitutes. Anxiety levels are higher in smokers than nonsmokers. Nonetheless smoking cessation for hospitalization does not increase these levels, even without nicotine substitutes. There is no interaction between anesthetic agents and nicotine substitutes: the latter may be continued through the morning of surgery and reinitiated in the immediate postoperative period. Patients who stop smoking for surgery should be encouraged to continue to stop, permanently. The general practitioner's support is essential for this.

New Practical Book Helps Nurses to Help Patients Stop Smoking Using the Five A's: Ask, Advise, Assess, Assist, Arrange

New Practical Book Helps Nurses to Help Patients Stop Smoking Using the Five A's: Ask, Advise, Assess, Assist, Arrange

The Effectiveness of a Nursing Inpatient Smoking Cessation Program in Individuals With Cardiovascular Disease

Smoking is an important risk factor for cardiovascular disease (CVD), and quitting is highly beneficial. Yet, less than 30% of CVD patients stop smoking. Relapse-prevention strategies seem most effective when initiated during the exacerbation of the disease. A nurse-delivered inpatient smoking cessation program based on the Transtheoretical Model with telephone follow-up tailored to levels of readiness to quit smoking was evaluated on smoking abstinence and progress to ulterior stages of change. Participants (N = 168) were randomly assigned by cohorts to inpatient counseling with telephone follow-up, inpatient counseling, and usual care. The inpatient intervention consisted of a 1-hr counseling session, and the telephone follow-up included 6 calls during the first 2 months after discharge. The nursing intervention was tailored to the individual's stage of change. End points at 2 and 6 months included actual and continuous smoking cessation rates (biochemical markers) and increased motivation (progress to ulterior stages of change). Assuming that surviving patients lost to follow-up were smokers, the 6-month smoking abstinence rate was 41.5% in the inpatient counseling with telephone follow-up group, compared with 30.2% and 20% in the inpatient counseling and usual care groups, respectively (p = .05). Progress to ulterior stages of change was 43.3%, 32.1%, and 18.2%, respectively (p = .02). Stage of change at baseline and intervention predicted smoking status at 6 months. This tailored smoking cessation program with telephone follow-up significantly increased smoking cessation at 6 months, and progression to ulterior stages of change. The telephone follow-up was an important adjunct. It is, therefore, recommended to include such comprehensive smoking cessation programs within hospital settings for individuals with CVD.

Seizing the Moment of Diagnosis to Help Patients Stop Smoking

Seizing the Moment of Diagnosis to Help Patients Stop Smoking