Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T10:55:03.188Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute Coronary Syndrome as a Teachable Moment for Smoking Cessation

Published online by Cambridge University Press:  16 December 2013

Geoffrey H. Tofler ,
Robin May ,
Roger Bartrop ,
Ann Kirkness ,
Helen Glinatsis  and
Simon de Burgh
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]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

smoking cessationteachable momentmyocardial infarction
Type
Articles
Information
Journal of Smoking Cessation , Volume 10 , Issue 1 , June 2015 , pp. 5 - 11
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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.)

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, 171–174. 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, 1814–1821.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, 28–35. 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, 699–703.Google Scholar
Frasure-Smith, N., Lesperance, F., & Talajic, M. (1995) Depression and 18-month prognosis after myocardial infarction. Circulation, 91, 999–1005.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, 615–624. 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, 12–24. 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, 56–66. 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, 791–800.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, 2557–2567.Google Scholar
Lando, H., Hennrikus, D., McCarty, M., & Vessey, J. (2003) Predictors of quitting in hospitalised smokers. Nicotine Tobacco Resources, 5, 215–222.Google Scholar
Lando, H. (2006) Reflections on 30+ years of smoking cessation research: from the individual to the world. Drug and Alcohol Review, 25, 5–14.Google Scholar
Lawson, P.J., & Flocke, S.A. (2009) Teachable moments for health behaviour change: a concept analysis. Patient Education and Counselling, 76, 25–30. 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, 44–46. 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, 156–170.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, 63–69.Google Scholar
McNeil, J., Piccenna, L., & Ioannides-Demos, L. (2010) Smoking cessation – recent advances. Cardiovascular Drugs Therapy, 24, 359–367. 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, 63–69.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, 329–346.Google Scholar
Shi, Y., & Warner, D.O. (2010) Surgery as a teachable moment for smoking cessation. Anaesthesiology, 112, 102–107. 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, 211–222.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, 118–123.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, 131–134. doi: 10.4103/0022-3859.52846.Google Scholar