Effectiveness of smoking cessation intervention in patients with cardiovascular disease

Introduction and objectives. The incidence of coronary events descends in patients with cardiac disease who quit smoking. Only around 50% of the patients who quit smoking after an acute event remain abstinent three months after hospital discharge. The objective of this study was to evaluate the effectiveness of a tobacco dishabituation program in patients with cardiovascular disease. Methods. We studied a cohort of smokers who started a smoking cessation program between September 1993 and June 1999. We compared 348 patients with cardiovascular disease with 1.107 smokers without disease. A twelve-month protocolized follow-up was performed, measuring carbon monoxide for evaluating relapse on every control. We calculated the abstinence in each period and estimated the odds ratio for relapse at twelve months. Results. We observed a global continued abstinence at twelve months of 37.1% (129/348) in the patients with cardiovascular disease and of 39.6% (438/1.107) in the patients without disease. The consonant smokers (pre-contemplatives) showed a greater number of relapses, with an adjusted Odds ratio of 1.36. Conclusions. Exhaustive treatment and follow-up achieved a percentage of great abstinence in the cardiovascular patients of our study who were unable to quit smoking during hospitalisation or after diagnosis. We therefore suggest that these patients may benefit from inclusion in smoking cessation units.