Smoking-Cessation Programs Never End
Smokers who suffer a heart attack may have better chance of quitting smoking if they get intensive consultation starting in the hospital, new research suggested.
In a trial of smokers who were hospitalized for a heart attack, those who were by accident assigned to an intensive smoking-cessation program which were more likely to be abstinent one year later.
Compared with patients who received a special nurse’s advice and some standard brochures while in the hospital, those in the intensive group were twice as likely to be tobacco-free after 1 year.
This smoking-cessation program began while patients were still in the hospital, with bedside counseling and advice. Patients then received take-home materials and phone-based counseling for 2 months after release from hospital.
“By significantly increasing abstinence among cardiac patients, inpatient programs for smoking cessation have the potential to produce considerable reductions in cardiac events and hospital costs,” write the investigators, led by Dr. Patricia M. Smith of the Northern Ontario School of Medicine.
Researchers have long called for hospitals to plainly offer heart patients smoking-cessation counseling. Nevertheless, such programs have not yet been widely adopted.
Randomly investigators assigned 276 heart patients at one hospital for to receive either intensive smoking-cessation counseling or “minimal” advice.
At the end of the investigation, after 12 months, 54 percent of patients in the intensive group were tobacco-free, based on reports from the patient and a family member or friend. That compared with 35 percent in the group that did not receive the intervention.
Patients in the intensive group were also twice as likely to be permanently abstinent during the 1-year follow-up.
“The rates of confirmed long-term abstinence observed in this trial are among the highest rates reported in cardiac populations and are among the highest reported absolute differences between minimal and intensive interventions,” write investigators.
They added that hospital counseling is more likely to help heart patients than the typical approach of offering intensive counseling only when patients have quit and then relapsed.
According to European studies, the five-year survival rate for post-transplant smokers is 37%, compared to 80% for nonsmoking recipients. Smokers can develop inoperable lung cancers within five years after a transplant, thus resulting in a shorter survival rate. There is an alarming incidence of head and neck cancers in transplant recipients who resume smoking.
Overall, there is a 90% relapse rate in the general population but, the more times a smoker tries to quit, the greater the chance of success with each new try.
