An estimated 30 to 45 percent of pa...

An estimated 30 to 45 percent of patients are believed to spontaneously stop smoking after having a coronary conclusion Smoking cessation after myocardial infarction is associated with a 50 percent reduction in mortality beyond three to five years, and this reduction increases through the whole extent of time. Studies have shown that brief interventions with patients in coronary care units are not as effective in increasing smoking cessation rates as are longer interventions. However, studies of longer interventions have relied forward patient self-reporting; only one investigation has attempted to verify smoking status biochemically. Quist-Paulsen and Gallefoss studied the impact of a smoking cessation program delivered by way of cardiac care nurses to patients in a Norwegian hospital's coronary care unit.

The patients were daily smoker and younger than 76 years of age who were being treated for myocardial infarction, unstable angina, or coronary artery bypass surgery Patients with short life-expectancies because of other medical conditions were exclud from the meditation Nurses recruited patients for the meditation two to four days after they were admitted and randomly allocated them to the intervention cluster or the control group (usual care).

All patients were proposeed group counseling sessions. The patients in the repress group received no further specific instructions forward how to stop smoking. In the intervention cluster the nurses worked with each patient during the hospital stay, using a booklet and materials that severityed the risks of continued smoking and the improved issues associated with cessation. Patients were advised to stop smoking, and those with cravings were exhibited nicotine replacement. Spouses also were advised to stop smoking. The festers telephoned each patient in the intervention cluster two days after discharge and again the same week, three weeks, three month and five month later to encourage cessation and deliver a fear arousal message based forward the original program. Patients were seen in the clinic at six weeks and united year. Smoking status was confirmed according to urine nicotine concentrations.

The 118 patients in the intervention dispose received one or two inpatient consultations and another united or two outpatient consultations, in addition to eight to nine telephone calls. The validated smoking cessation rates at the same year were 57 percent in the intervention form into groups and 37 percent in the rule group. The number needed to treat was five to commit to memory one additional patient to stop smoking.

The authors bring to an end that a program based forward fear arousal and relapse prevention and delivered through cardiac nurses is effective in enhancing smoking cessation rates in patients hospitalized for cardiac conditions.

Quist-Paulsen P Gallefoss F Randomised controll trial of smoking cessation intervention after admission for coronary heart disease. BMJ November 29 2003;327:1254-7

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