kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2016.16.1.48 kjhp-16-48 Original Article Continuous Abstinence Rates from Smoking Over 12 Months according to the Frequency of Participation in a Hospital-based Smoking Cessation Program among Patients Discharged after Acute Myocardial Infarction LeeYoung-Hoon 1 2 3 HanMi-Hee 3 LeeMi Rim 2 JeongJin-Won 2 4 KimNam-Ho 2 4 OhSeok Kyu 2 4 YunKyeong Ho 2 4 RheeSang Jae 2 4 KoJum Suk 2 4 OhGyung-Jae 1 2 3 Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea Jeonbuk Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea Jeonbuk Tobacco Control Center, Wonkwang University Hospital, Iksan, Korea Division of Cardiology, Department of Internal Medicine, Wonkwang University School of Medicine and Hospital, Iksan, Korea Corresponding author: Gyung-Jae Oh, MD, PhD Institute of Wonkwang Medical Science, Department of Preventive Medicine, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 54538, Korea Tel: +82-63-850-6781, Fax: +82-63-859-1995 E-mail: pmokj@wonkwang.ac.kr 01 2016 20 01 2016 16 1 48 55 19072015 05022015 Copyright © 2016 The Korean Society of Health Promotion and Disease Prevention 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

This study evaluated the continuous abstinence rates from smoking at 12-month after a hospital-based smoking cessation program was applied for smokers hospitalized for acute myocardial infarction.

 Methods

Among those who are hospitalized for acute myocardial infarction from January 2012 to December 2013, ninety-eight smokers agreed to quit smoking were eligible for follow up to 12 months. Each of them underwent six consecutive sessions (first during admission, the other 5 sessions after discharge) of behavioral modification, counseling for withdrawal symptoms, and anti-smoking advices by a trained nurse. Exhaled carbon monoxide measurements less than 6 ppm were used to confirm the smoking cessation status of each participant.

 Results

Mean age of all participants was 55.2±10.8 years old, and their continuous abstinence rates at 1, 3, 6, 12 months were 63.3%, 49.0%, 43.9%, and 37.8% for each. The continuous abstinence rate from smoking after 12 months was 69.7% and significantly higher in those who completed the 6 sessions than 21.5% in those who completed 5 sessions or less (P＜0.001). After adjustment for general and smoking-related characteristics, multivariate logistic regression analysis revealed that full participation relative to 5 or less participation was significantly associated with higher continuous abstinence rate from smoking at 12 months (odds ratio: 7.96; 95% confidence interval: 2.07–30.55).

 Conclusions

The consistency of participating in a hospital-based smoking cessation program, described herein, significantly improved success rates of smoking cessation in patients discharged after acute myocardial infarction. Hospital-based smoking cessation program based on education and counseling should be included as an important part of patient management for acute myocardial infarction.

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Continuous abstinence rates from smoking decreased from 63.3% at 1 month to 37.8% at 12 month in patients discharged after acute myocardial infarction who participated in hospital-based smoking-cessation program.

Continuous abstinence rates from smoking were higher in patients discharged after acute myocardial infarction who participated in smoking-cessation program of 6 times versus ≤5 times.

General characteristics of subjects according to the frequency of participating in smoking cessation program

  Total (n＝98) ≤ 5 times (n＝65) 6 times (n＝33) Pa
  n n n
Age, y 55.2±10.8 55.9±10.7 53.8±11.0 0.362
＜60 68 (69.4) 20 (69.2) 23 (69.7) 0.962
≥ 60 30 (30.6) 10 (30.8) 10 (30.3)  
Duration of education, y        
≤ 9 40 (40.8) 28 (43.1) 12 (36.4) 0.523
≥ 10 58 (59.2) 37 (56.9) 21 (63.6)  
Health insurance        
Medical aid 8 (8.2) 5 (7.7) 3 (9.1) 0.811
National health insurance 90 (91.8) 60 (92.3) 30 (90.9)  
Family type        
Living alone 25 (25.5) 18 (27.7) 7 (21.2) 0.268
Living with family 65 (66.3) 40 (61.5) 25 (75.8)  
Non-response 8 (8.2) 7 (10.8) 1 (3.0)  
Occupation        
Manual 44 (44.9) 26 (40.0) 18 (54.5) 0.182
Non-manual 14 (14.3) 12 (18.5) 2 (6.1)  
Others (unemployed, housewife, non-response) 40 (40.8) 27 (41.5) 13 (39.4)  
Alcohol drinking        
No 64 (65.3) 43 (66.2) 21 (63.6) 0.805
Yes 34 (34.7) 22 (33.8) 12 (36.4)  
Hypertension        
Absent 65 (66.3) 43 (66.2) 22 (66.7) 0.960
Present 33 (33.7) 22 (33.8) 11 (33.3)  
Diabetes mellitus        
Absent 78 (79.6) 49 (75.4) 29 (87.9) 0.147
Present 20 (20.4) 16 (24.6) 4 (12.1)  
Dyslipidemia        
Absent 89 (90.8) 58 (89.2) 31 (93.9) 0.446
Present 9 (9.2) 7 (10.8) 2 (6.1)  
Past history of coronary heart disease        
No 91 (92.9) 60 (92.3) 31 (93.9) 0.767
Yes 7 (7.1) 5 (7.7) 2 (6.1)  
Killip class        
Ⅰ 93 (94.9) 62 (95.4) 31 (93.9) 0.759
Ⅱ-Ⅳ 5 (5.1) 3 (4.6) 2 (6.1)  

Values are presented as N (%) or mean±SD.

Calculated by chi-square test or independent t-test.

Smoking-related characteristics of subjects according to the frequency of participating in smoking cessation program

  Total (n＝98) ≤ 5 times (n＝65) 6 times (n＝33) Pa
  n n n
Presence of smokers among family members       0.834
Absent 22 (22.4) 15 (23.1) 7 (21.2)  
Present 76 (77.6) 50 (76.9) 26 (78.8)  
Previous exposure to anti-smoking education       0.979
No 86 (87.8) 57 (87.7) 29 (87.9)  
Yes 12 (12.2) 8 (12.3) 4 (12.1)  
Previous attempts to quit smoking       0.026
No 42 (42.9) 33 (50.8) 9 (27.3)  
Yes 56 (57.1) 32 (49.2) 24 (72.7)  
Amount of smoking       0.139
＜1 pack 71 (72.4) 44 (67.7) 27 (81.8)  
≥ 1 pack 27 (27.6) 21 (32.3) 6 (18.2)  
Age at starting smoking       0.831
＜20 yr 49 (50.0) 33 (50.8) 16 (48.5)  
≥ 20 yr 49 (50.0) 32 (49.2) 17 (51.5)  
Duration of smoking, y       0.577
＜30 32 (32.7) 20 (30.8) 12 (32.7)  
≥ 30 66 (67.3) 45 (69.2) 21 (67.3)  
Participation in a heart rehabilitation program       0.171
0 sessions 39 (39.8) 29 (44.6) 10 (30.3)  
≥ 1 sessions 59 (60.2) 36 (55.4) 23 (69.7)  
Participation in a follow-up heart education       ＜0.001
0 sessions 38 (38.8) 35 (53.8) 3 (9.1)  
≥ 1 sessions 60 (61.2) 30 (46.2) 30 (90.9)  

Values are presented as N (%).

Calculated by chi-square test.

OR (95% CI) for persistent smoking cessation after 6 and 12 month according to the frequency of participating in smoking cessation program in patient with myocardial infarction

  After 6 month After 12 month
  OR (95% CI) OR (95% CI)
Frequency of smoking cessation program
≤ 5 times 1.00 1.00
6 times 10.36 (2.36–45.59) 7.96 (2.07–30.55)

Abbreviations: OR, odds ratio; CI, confidence interval. Adjusted for age, duration of education, health insurance, family type, occupation, alcohol drinking, hypertension, diabetes mellitus, dyslipidemia, past history of coronary heart disease, Killip class, presence of smokers among family members, previous exposure to anti-smoking education, previous attempts to quit smoking, amount of smoking, age at starting smoking, duration of smoking, participation in a heart rehabilitation program, and participation in a follow-up heart education