Elsevier

Preventive Medicine

Volume 30, Issue 4, April 2000, Pages 261-268
Preventive Medicine

Lead Article
A Randomized Controlled Trial of Smoking Cessation Counseling after Myocardial Infarction,☆☆

https://doi.org/10.1006/pmed.2000.0644Get rights and content

Abstract

Background. Smoking cessation after myocardial infarction (MI) has been associated with a 50% reduction in mortality but in-hospital smoking cessation interventions are rarely part of routine clinical practice.

Methods. One hundred cigarette smokers consecutively admitted during 1996 with MI were assigned to minimal care or to a hospital-based smoking cessation program. Intervention consisted of bedside cessation counseling followed by seven telephone calls over the 6 months following discharge. Primary outcomes were abstinence rates measured at 6 months and 1 year post-discharge.

Results. At follow-up, 43 and 34% of participants in minimal care and 67 and 55% of participants in intervention were abstinent at 6 and 12 months. respectively (P < 0.05). Abstinence rates were calculated assuming that participants lost to attrition were smokers at follow-up. Intervention and self-efficacy were independent predictors of smoking status at follow-up. Low self-efficacy combined with no intervention resulted in a 93% relapse rate by 1 year (P < 0.01).

Conclusions. A hospital-based smoking cessation program consisting of inpatient counseling and telephone follow-up substantially increases smoking abstinence 1 year after discharge in patients post-MI. Patients with low self-efficacy are almost certain to relapse without intervention. Such smoking cessation programs should be part of the management of patients with MI.

References (46)

  • MC Rosal et al.

    Coronary Artery Smoking Intervention Study (CASIS): 5-year follow-up

    Health Psychol

    (1998)
  • NA Rigotti et al.

    Predictors of smoking cessation after coronary artery bypass graft surgery. Results of a randomized trial with 5-year follow-up

    Ann Int Med

    (1994)
  • RF DeBusk et al.

    A case management system for coronary risk factor modification after acute myocardial infarction

    Ann Int Med

    (1994)
  • VJ Stevens et al.

    A smoking cessation intervention for hospital patients

    Med Care

    (1993)
  • NA Rigotti et al.

    Efficacy of a smoking cessation program for hospital patients

    Arch Intern Med

    (1997)
  • American Heart Association, Active partnership: toward a healthier heart (video),...
  • JO Prochaska et al.

    Stages and processes of self-change of smoking: Toward an integrative model

    J Clin Consult Psychol

    (1983)
  • A Bandura

    Social foundations of thought and action: a social cognitive theory

    (1986)
  • CC DiClemente et al.

    The process of smoking cessation: an analysis of precontemplation, contemplation and preparation stages of change

    J Clin Consult Psychol

    (1991)
  • BH Marcus et al.

    The stages and processes of exercise adoption and maintenance in a worksite sample

    Health Psych

    (1992)
  • WR Miller et al.

    Motivational interviewing: preparing people to change addictive behavior

    (1991)
  • GA Marlatt et al.

    Relapse prevention: maintenance strategies in the treatment of addictive behaviors

    (1985)
  • Cited by (0)

    This study was supported in part by Hartford Hospital Grant 127002.

    ☆☆

    We gratefully acknowledge the assistance of Amanda Botticello, Jennifer Goldschmidt, and Beth Ann Collins, R.N., M.S., in completing this study. We also thank Dr. Edward Fischer and Dr. John Goethe for their consultation on this study.

    1

    To whom correspondence and reprint requests should be addressed at Preventive Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102. Fax: (860) 545-3168. E-mail: [email protected].

    View full text