Tobacco Cessation Among Acute Coronary Syndrome Patients in Kerala, India: Patient and Provider Perspectives

被引:2
|
作者
Bhaumik, Smitha S. [1 ]
Placek, Caitlyn [2 ]
Kochumoni, R. [3 ]
Lekha, T. R. [4 ]
Prabhakaran, Dorairaj [6 ,7 ]
Hitsman, Brian [12 ]
Huffman, Mark D. [9 ,10 ]
Harikrishnan, Sivadasanpillai [4 ,5 ]
Goenka, Shifalika [6 ,8 ,11 ]
机构
[1] Denver Hlth Med Ctr, Emergency Med, Denver, CO USA
[2] Ball State Univ, Biol Anthropol, Muncie, IN 47306 USA
[3] Cardiol Soc India, Kerala Chapter, Trivandrum, Kerala, India
[4] Sree Chitra Tirunal Inst Med Sci & Technol, Trivandrum, Kerala, India
[5] Sree Chitra Tirunal Inst Med Sci & Technol, Cardiol, Trivandrum, Kerala, India
[6] Ctr Chron Dis Control, Gurgaon, Haryana, India
[7] Publ Hlth Fdn India, Res & Policy, Gurgaon, Haryana, India
[8] Publ Hlth Fdn India, Gurgaon, Haryana, India
[9] Northwestern Univ, Hlth Policy, Feinberg Sch Med, Chicago, IL 60611 USA
[10] Northwestern Univ, Prevent Med & Med Cardiol, Feinberg Sch Med, Chicago, IL 60611 USA
[11] Indian Inst Publ Hlth Delhi, Gurgaon, Haryana, India
[12] Northwestern Univ, Prevent Med, Feinberg Sch Med, Chicago, IL 60611 USA
基金
美国国家卫生研究院;
关键词
tobacco cessation; India; qualitative research; smoking; heart attacks; cardiac events; quitting; qualitative; framework analysis; South Asia; SMOKING-CESSATION; GENERAL-PRACTITIONERS; PREVENTION; MORTALITY; BEHAVIOR; BARRIERS; RISK;
D O I
10.1177/1049732318817047
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Tobacco cessation is an important intervention to reduce mortality from ischemic heart disease, the leading cause of death in India. In this study, we explored facilitators, barriers, and cultural context to tobacco cessation among acute coronary syndrome (ACS, or heart attack) patients and providers in a tertiary care institution in the south Indian state of Kerala, with a focus on patient trajectories. Patients who quit tobacco after ACS expressed greater understanding about the link between tobacco and ACS, exerted more willpower at the time of discharge, and held less fatalistic beliefs about their health compared to those who continued tobacco use. The former were motivated by the fear of recurrent ACS, strong advice to quit from providers, and determination to survive and financially provide for their families. Systemic barriers included inadequate training, infrequent prescription of cessation pharmacotherapy, lack of ancillary staff to deliver counseling, and stigma against mental health services.
引用
收藏
页码:1145 / 1160
页数:16
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