Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T22:07:19.894Z Has data issue: false hasContentIssue false
  • English
  • Français

Smoking Abstinence Twelve Months after an Acute Coronary Syndrome

Published online by Cambridge University Press:  20 November 2017

Vânia Rocha ,
Marina P. Guerra ,
Marina S. Lemos ,
Júlia Maciel  and
Geoffrey C. Williams
Vânia Rocha*
Affiliation:
Universidade do Porto (Portugal)
Marina P. Guerra
Affiliation:
Universidade do Porto (Portugal)
Marina S. Lemos
Affiliation:
Universidade do Porto (Portugal)
Júlia Maciel
Affiliation:
Universidade do Porto (Portugal)
Geoffrey C. Williams
Affiliation:
University of Rochester (USA)
*
*Correspondence concerning this article should be addressed to Vânia Rocha. Universidade do Porto, Faculdade de Psicologia e de Ciências da Educação. Porto (Portugal). 4200–135. Portugal. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Studies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge. The results showed that anxiety (F(2, 62) = 28.10, p < .001, ηp2 = .48) and depressive symptoms (F(2, 62) = 10.42, p < .001, ηp2 = .25) decreased over time, whereas meaning in life (F(2, 61) = 44.77, p < .001, ηp2 = .59) and social support increased (t(63) = –4.54, p < .001, 95% IC[–11.05, 4.29], η2 =.25). Smoking dependence was negatively predicted by change in perceived competence (B = –2.25, p = .011, 95% IC[.02, .60]) and positively by change in depressive symptoms (B =.37, p = .042, 95% IC[1.01, 2.05]) 12 months after clinical discharge. Nicotine dependence (t(17) = 2.76, p = .014, 95% IC[.39, 2.94], η2 =.31) and the number of cigarettes smoked per day (t(17) = 4.48, p < .001, 95% IC[5.49, 15.29], η2 =.54) decreased over time, whereas behavioral dependence increased among smokers (t(17) = –2.37, p = .030, 95% IC[–4.30, 2.54], η2 =.25). This study suggests that long term abstinence in cardiac patients may be enhanced by psychological interventions addressing perceived competence, depressive symptoms and behavioral dependence.

Keywords

acute coronary syndromebehavioral dependencedepressive symptomsperceived competencesmoking
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 20 , 2017 , E63
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

How to cite this article:

Rocha, V, Guerra, M. P., Lemos, M. S., Maciel, J., & Williams, G. C. (2017). Smoking abstinence twelve months after an acute coronary syndrome. The Spanish Journal of Psychology, 20. e63. Doi:10.1017/sjp.2017.61

References

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Barnason, S., Zimmerman, L., Nieveen, J., Schultz, P., & Young, L. (2012). Patient recovery and transitions after hospitalization for acute cardiac events: An integrative review. Journal of Cardiovascular Nursing, 27, 175–191. https://doi.org/10.1097/JCN.0b013e318239f5f5 CrossRefGoogle ScholarPubMed
Boersma, S. N., Maes, S., & Joekes, K. (2005). Goal disturbance in relation to anxiety, depression, and health-related quality of life after myocardial infarction. Quality of Life Research, 14, 2265–2275. https://doi.org/10.1007/s11136-005-7406-3 CrossRefGoogle ScholarPubMed
Deci, E. L., & Ryan, R. M. (2000). The ’what’ and ’why’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227–268.Google Scholar
Falba, T., Jofre-Bonet, M., Busch, S., Duchovny, N., & Sindelar, J. (2004). Reduction of quantity smoked predicts future cessation among older smokers. Addiction, 99, 93–102. https://doi.org/10.1111/j.1360-0443.2004.00574.x Google Scholar
Ferreira, P., Quintal, C., Lopes, I., & Taveira, N. (2009). Teste de dependência à nicotina: Validação linguística e psicométrica do teste de Fagerström [Nicotine dependence test: Linguistic and psychometric validation of the Fagerström Test]. Revista Portuguesa de Saúde Pública, 27, 37–56.Google Scholar
Gavina, C., Pinho, T., & Maciel, J. (2011). Enfarte agudo do miocárdio [Acute myocardial infarction]. Vila do Conde, Portugal: QuidNovi.Google Scholar
Glover, E. D., Nilsson, F., Westin, A., Glover, P. N., Laflin, M. T., & Persson, B. (2005). Developmental history of the Glover-Nilsson smoking behavioral questionnaire. American Journal of Health Behavior, 29, 443–455. https://doi.org/10.5993/AJHB.29.5.7 CrossRefGoogle ScholarPubMed
Guerra, M. P. (1992). Conceito de auto-actualização, elaboração de uma escala e avaliação das suas qualidades psicométricas [The concept of self-actualization, the development of a scale and its psychometric assessement]. Psychologica, 7, 95–109.Google Scholar
Guerra, M. (1995). Uma escala de avaliação do suporte social: Aplicação numa população seropositiva ao vírus HIV [A scale of social support: Administration in a HIV-positive population]. Avaliação Psicológica: Formas e Contextos, 3, 25–34.Google Scholar
Guerra, M., Lemos, M., Queirós, C., & Rosas, M. (2003, July). Level of self-determination in adults quitting smoking. Poster session presented at the 17th Annual Conference of the European Health Psychology Society, Kos, Greece.Google Scholar
Guerra, M., Lencastre, L., Silva, E., & Teixeira, P. (2017). Meaning in life in medical settings: A new measure correlating with psychological variables in disease. Cogent Psychology, 4, 1286747. https://doi.org/10.1080/23311908.2017.1286747 Google Scholar
Guerra, M., Queirós, C., Torres, S., Vieira, F., Branco, C., & Garrett, S. (2008). O consumo de tabaco numa instituição universitária: Prevalência e características do fumador. [Tobacco consumption at a university: Prevalence and characteristics of the smoker]. Análise Psicológica, 26, 209–226.Google Scholar
Heatherton, T., Kozlowski, L., Frecker, R., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86, 1119–1127.Google Scholar
Heintzelman, S., & King, L. (2014). Life is pretty meaningful. American Psychologist, 69, 561–574. https://doi.org/10.1037/a0035049 CrossRefGoogle ScholarPubMed
Holtrop, J. S., Stommel, M., Corser, W., & Holmes-Rovner, M. (2009). Predictors of smoking cessation and relapse after hospitalization for acute coronary syndrome. Journal of Hospital Medicine, 4, 3–9. https://doi.org/10.1002/jhm.415 CrossRefGoogle ScholarPubMed
Kim, E. S., Sun, J. K., Park, N., Kubzansky, L. D., & Peterson, C. (2013). Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: A two-year follow-up. Journal of Behavioural Medicine, 36, 124–133. https://doi.org/10.1007/s10865-012-9406-4 Google Scholar
Lévesque, C. S., Williams, G. C., Elliot, D., Pickering, M. A., Bodenhamer, B., & Finley, P. J. (2007). Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health Education Research, 22, 691–702.Google Scholar
Lin, N., Dean, A., & Ensel, W. (1986). Social support, life events and depression. New York, NY: Academic Press.Google Scholar
McClave, A., Dube, S., Strine, T., Kroenke, K., Caraballo, R., & Mokdad, A. (2009). Associations between smoking cessation and anxiety and depression among U.S. adults. Addictive Behaviors, 34, 491–497. https://doi.org/10.1016/j.addbeh.2009.01.005 Google Scholar
Park, E. W., Tudiver, F., Schultz, J. K., & Campbell, T. (2004). Does enhancing partner support and interaction improve smoking cessation? A meta-analysis. Annals of Family Medicine, 2, 170–174. https://doi.org/10.1370/afm.64 Google Scholar
Perez, G. H., Nicolau, J. C., Romano, B. W., & Laranjeira, R. (2008). Depression: A predictor of smoking relapse in a 6-month follow-up after hospitalization for acute coronary syndrome. European Journal of Cardiovascular Prevention and Rehabilitation, 15, 89–94. https://doi.org/10.1097/HJR.0b013e3282f4b212 Google Scholar
Programa Nacional para a Prevenção e Controlo do Tabagismo (2016). Portugal - prevenção e controlo do tabagismo em números 2015 [Portugal – smoking prevention and control in numbers 2015]. Lisboa, Portugal: Direcção Geral de Saúde.Google Scholar
Quist-Paulsen, P., Bakke, P. S., & Gallefoss, F. (2005). Predictors of smoking cessation in patients admitted for acute coronary heart disease. European Journal of Preventive Cardiology, 12, 472–477. https://doi.org/10.1097/01.hjr.0000183914.90236.01 Google Scholar
Rath, J. M., Sharma, E., & Beck, K. H. (2013). Reliability and validity of the Glover-Nilsson smoking behavioral questionnaire. American Journal of Health Behavior, 37, 310–317. https://doi.org/10.5993/AJHB.37.3.3 Google Scholar
Ribeiro, J. P., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the hospital anxiety and depression scale. Psychology, Health & Medicine, 12, 225–237. https://doi.org/10.1080/13548500500524088 Google Scholar
Rocha, V., Guerra, M., Lemos, M. S., & Glover, E. D. (2014). Validation of the Glover-Nilsson Smoking Behavioral Questionnaire for the Portuguese population: A psychometric process. American Journal of Health Behavior, 38, 801–806. https://doi.org/10.5993/AJHB.38.6.1 Google Scholar
Rocha, V., Guerra, M., Lemos, M., Maciel, M., & Williams, G. (2017). Motivation to quit smoking after acute coronary syndrome. Acta Médica Portuguesa, 30, 34–40. https://doi.org/10.20344/amp.7926 CrossRefGoogle ScholarPubMed
Rocha, V., Guerra, M., & Maciel, J. (2010). Dependência tabágica, assertividade e alexitimia em doentes cardíacos [Tobacco dependence, assertiveness and alexithymia in cardiac patients]. Paidéia, 20, 155–164.Google Scholar
Rodgers, W. M., Markland, D., Selzler, A. M., Murray, T. C., & Wilson, P. M. (2014). Distinguishing perceived competence and self-efficacy: An example from exercise. Research Quarterly for Exercise and Sport, 85, 527–539. https://doi.org/10.1080/02701367.2014.961050 CrossRefGoogle ScholarPubMed
Royal College of Physicians. (2007). Harm reduction in nicotine addiction: Helping people who can’t quit. A report by the tobacco advisory group of the Royal College of Physicians. London, UK: RCP.Google Scholar
Thege, B., Bachner, Y., Martos, T., & Kushnir, T. (2009). Meaning in life: Does it play a role in smoking?. Substance Use & Misuse, 44, 1566–1577. https://doi.org/10.3109/10826080802495096 Google Scholar
Thurston, R. C., & Kubzansky, L. D. (2007). Multiple sources of psychosocial disadvantage and risk of coronary heart disease. Psychosomatic Medicine, 69, 748–755. https://doi.org/10.1097/PSY.0b013e31815772a3 CrossRefGoogle ScholarPubMed
Trigo, M., & Rocha, E. (2002). Cessação de hábitos tabágicos em doentes coronários [Smoking habits cessation in coronary patients]. Acta Médica Portuguesa, 15, 337–344.Google Scholar
Uchino, B. N. (2006). Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29, 377–387. https://doi.org/10.1007/s10865-006-9056-5 Google Scholar
Williams, G. C., & Deci, E. L. (1996). Internalization of biopsychosocial values by medical students: A test of Self-Determination Theory. Journal of Personality and Social Psychology, 70, 767–779. https://doi.org/10.1037/0022-3514.70.4.767 Google Scholar
Williams, G. C., Gagné, M., Mushlin, A. I., & Deci, E. (2005). Motivation for behavior change in patients with chest pain. Health Education, 105, 304–321. https://doi.org/10.1108/09654280510602516 Google Scholar
Williams, G. C., Gagné, M., Ryan, R. M., & Deci, E. L. (2002). Facilitating autonomous motivation for smoking cessation. Health Psychology, 21, 40–50. https://doi.org/10.1037//0278-6133.21.1.40 Google Scholar
Williams, G. C., Niemiec, C. P., Patrick, H., Ryan, R. M., & Deci, E. L. (2009). The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence. Annals of Behavioral Medicine, 37, 315–324. https://doi.org/10.1007/s12160-009-9090-y Google Scholar
World Health Organization. (2012). Global report: Mortality attributable to tobacco. Geneva, Switzerland: WHO Press.Google Scholar
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x CrossRefGoogle ScholarPubMed