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

Young-Hoon Lee; Mi-Hee Han; Mi Rim Lee; Jin-Won Jeong; Nam-Ho Kim; Seok Kyu Oh; Kyeong Ho Yun; Sang Jae Rhee; Jum Suk Ko; Gyung-Jae Oh

doi:10.15384/kjhp.2016.16.1.48

Korean J Health Promot > Volume 16(1); 2016 > Article

Lee, Han, Lee, Jeong, Kim, Oh, Yun, Rhee, Ko, and Oh: 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

Original Article

Korean Journal of Health Promotion 2016;16(1):48-55.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.1.48

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

Young-Hoon Lee^1,^2,³, Mi-Hee Han³, Mi Rim Lee², Jin-Won Jeong^2,⁴, Nam-Ho Kim^2,⁴, Seok Kyu Oh^2,⁴, Kyeong Ho Yun^2,⁴, Sang Jae Rhee^2,⁴, Jum Suk Ko^2,⁴, Gyung-Jae Oh^1,^2,^3,

¹Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea

²Jeonbuk Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea

³Jeonbuk Tobacco Control Center, Wonkwang University Hospital, Iksan, Korea

⁴Division 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

Received July 19, 2015 Accepted February 05, 2015

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.

ABSTRACT

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.

Figure 1.

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.

Figure 2.

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.

Table 1.

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)	P^a
	n	n	n	P^a
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.

^aCalculated by chi-square test or independent t-test.

Table 2.

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)	P^a
	n	n	n	P^a
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 (%).

^aCalculated by chi-square test.

Table 3.

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

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