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Acute Coronary Syndrome as a Teachable Moment for Smoking Cessation

Published online by Cambridge University Press:  16 December 2013

Geoffrey H. Tofler*
Affiliation:
Department of Cardiology, Royal North ShoreHospital, University of Sydney, Australia
Robin May
Affiliation:
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, Australia
Roger Bartrop
Affiliation:
Department of Psychiatry, Royal North Shore Hospital, University of Sydney, Australia
Ann Kirkness
Affiliation:
Cardiac Rehabilition, Royal North Shore Hospital, University of Sydney, Australia
Helen Glinatsis
Affiliation:
Cardiac Rehabilition, Royal North Shore Hospital, University of Sydney, Australia
Simon de Burgh
Affiliation:
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, Australia
*
Address for correspondence: Geoffrey H. Tofler, Royal North Shore Hospital, St Leonards, NSW 2065. E-mail: [email protected]

Abstract

Introduction: Although the teachable moment has been recognised as an important contributor to behaviour change, its role in smoking cessation merits further investigation.

Aim: We prospectively evaluated 116 patients hospitalised with a suspected acute coronary syndrome in two tertiary referral hospitals. The patients comprised 84 men and 32 women, aged 54.2 ± 8.5 years, and the final diagnosis was myocardial infarction in 90 and angina in 26.

Results/Findings: At one month, the self-reported quit rate was 65%, maintained to 61% at 12 months. The quit rate was greater at one and 12 months for those diagnosed with myocardial infarction (70% and 67%) compared with those who had angina (46% and 40%), p<0.05. The strongest motivators for quitting were the heart attack and the consequences of the diagnosis. Of those who quit at 1 month, 77% did so without additional aids.

Conclusions: Hospitalisation with an acute coronary syndrome is associated with a high quit rate, and the diagnosis of heart attack with its potential consequences represents a strong teachable moment to stop smoking. The findings support further investigation of the teachable moment to aid in smoking cessation.

Type
Articles
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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References

Aziz, O., Skapinakis, P., Rahman, S., Rao, C., Ashrafian, H., Panessar, S.S., . . . Athanasiou, T. (2009) Behavioural interventions for smoking cessation in patients hospitalised for a major cardiovascular event. International Journal of Cardiology, 137, 171174. doi: 10.1016/j.ijcard.2008.05.029.Google Scholar
Berlin, I., & Covey, L.S. (2006) Pre-cessation depressive mood predicts failure to quit smoking: the role of coping and personality traits. Addiction, 101, 18141821.CrossRefGoogle ScholarPubMed
Cosci, F., Corlando, A., Fornai, E., Pistelli, F., Paoletti, P., & Carrozzi, L. (2009) Nicotine dependence, psychological distress and personality traits as possible predictors of smoking cessation. Results of a double-blind study with nicotine patch. Addiction Behaviours, 34, 2835. doi: 10.1016/j.addbeh.2008.08.003.Google Scholar
Crouse, J.R. III, & Hagaman, A.P. (1991) Smoking cessation in relation to cardiac procedures. American Journal of Epidemiology, 134, 699703.Google Scholar
Frasure-Smith, N., Lesperance, F., & Talajic, M. (1995) Depression and 18-month prognosis after myocardial infarction. Circulation, 91, 9991005.CrossRefGoogle ScholarPubMed
Gilman, S.E., Martin, L.T., Abrams, D.B., Kawachi, I., Kubzansky, L., Loucks, E.B., Rende, R., Rudd, R., & Buka, S.L. (2008) Education attainment and cigarette smoking: a causal association? International Journal of Epidemiology, 37, 615624. doi: 10.1093/ije/dym250.Google Scholar
Gorber, S.C., Schofield-Hurwitz, S., Hardt, J., Levasseur, G., & Tremblay, M. (2009) The accuracy of self-reported smoking: A systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tobacco Resources, 11, 1224. doi: 10.1093/ntr/ntn010.Google Scholar
Gwaltney, C.J., Metrik, J., Kahler, C.W., & Shiffman, S. (2009) Self-efficacy and smoking cessation: A meta-analysis. Psychology of Addictive Behaviours, 23, 5666. doi: 10.1037/a0013529.CrossRefGoogle ScholarPubMed
Heatherton, T.F., Kozlowski, L.T., Frecker, R.C., Rickert, W., & Robinson, J. (1989) Measuring the heaviness of smoking: Using self-reported time to the first cigarette of the day and number of cigarettes per day. British Journal of Addiction, 84, 791800.Google Scholar
Homish, G.G., & Leonard, K.E. (2005) Spousal influence on smoking behaviours in a US community sample of newly married couples. Social Science and Medicine, 61, 25572567.Google Scholar
Lando, H., Hennrikus, D., McCarty, M., & Vessey, J. (2003) Predictors of quitting in hospitalised smokers. Nicotine Tobacco Resources, 5, 215222.Google Scholar
Lando, H. (2006) Reflections on 30+ years of smoking cessation research: from the individual to the world. Drug and Alcohol Review, 25, 514.Google Scholar
Lawson, P.J., & Flocke, S.A. (2009) Teachable moments for health behaviour change: a concept analysis. Patient Education and Counselling, 76, 2530. doi: 10.1016/j.pec.2008.11.002.Google Scholar
Marlatt, G.A., & Donovan, D. (2005) Relapse Prevention. 2nd ed. New York: Guilford Press.Google Scholar
May, R., Tofler, G.H., Bartrop, R., Heinrich, P., Baird, J., Jozefiak, E., & de Burgh, S. (2010) Smoking cessation through a novel behaviour modification technique. American Journal of Cardiology, 106, 4446. doi: 10.1016/j.amjcard.2010.02.010.Google Scholar
McBride, C., Emmons, K., & Lipkus, I. (2003) Understanding the potential of teachable moments: the case of smoking cessation. Health Education Resources, 18, 156170.Google Scholar
McBride, C.M., Curry, S.J., Grothaus, L.C., Nelson, J.C., Lando, H., & Pirie, P.L. (1998) Partner smoking status and pregnant smoker's perception of support for and likelihood of smoking cessation. Health Psychology, 17, 6369.Google Scholar
McNeil, J., Piccenna, L., & Ioannides-Demos, L. (2010) Smoking cessation – recent advances. Cardiovascular Drugs Therapy, 24, 359367. doi: 10.1007/s10557-010-6246-8.Google Scholar
Ong, K.C., Cheong, G.N., Prabhakaran, L., & Earnest, A. (2005) Predictors of success in smoking cessation among hospitalised patients. Respirology, 10, 6369.Google Scholar
Rohrbaugh, M.J., Shoham, V., & Dempsey, C.L. (2009) Gender differences in quit support by partners of health-compromised smokers. Journal of Drug Issues, 39, 329346.Google Scholar
Shi, Y., & Warner, D.O. (2010) Surgery as a teachable moment for smoking cessation. Anaesthesiology, 112, 102107. doi: 10.1097/ALN.0b013e3181c61cf9.Google Scholar
Smith, P.M, Reilly, K.R., Houston-Miller, N., DeBusk, R.F., & Taylor, C.B. (2002) Application of a nurse-managed smoking cessation program. Nicotine Tobacco Resources, 4, 211222.Google Scholar
Taylor, C.B., Houston-Miller, N., Killen, J.D., & DeBusk, R.F. (1990) Smoking cessation after acute myocardial infarction: effect of a nurse-managed intervention. Annals of International Medicine, 113, 118123.Google Scholar
Puri, K.S., Suresh, K.R., Gogtay, N.J., & Thatte, U.M. (2009) Declaration of Helsinki, 2008: implications for stakeholders in research. Journal of Postgraduate Medicine, 55, 131134. doi: 10.4103/0022-3859.52846.Google Scholar