Categories
· Health/Science
· Cessation
· Cardio-vascular
· Hospitals/Medical facilities
non-USA, by Country
· Canada
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Jump to full article: Canadian Medical Association Journal (ca), 2009-06-23
Author: Patricia M. Smith, PhD and Ellen Burgess, MD
Intro: Interpretation
More patients in the intensive intervention than in the minimal intervention were abstinent at 1 year (absolute increase of 19%). The odds of quitting smoking were 2 times greater for those in the intensive intervention. The unique contributions of this study include significantly higher rates of continuous abstinence for patients admitted to hospital for CABG than for acute MI, significantly lower rates of abstinence among patients who used pharmacotherapy regardless of the intervention group (which is a finding consistent with general hospital patients) 28 and real-time tracking of the prevalence of tobacco use among patients admitted for acute MI or CABG. The prevalence of tobacco use was higher for patients with acute MI (34%) than the provincial average of smoking prevalence (22%-24%), 29 which is an important consideration for case-load estimation. In addition to receiving the intensive intervention, the absence of a previous acute MI and having a postsecondary education and at least some restrictions on smoking at home contributed to successful long-term cessation of tobacco use.
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. 8 Our results suggest that intensive counselling provided during the hospital stay is more effective than a stepped-care approach that provides intensive counselling only after a patient has relapsed. 30 By significantly increasing abstinence among cardiac patients, inpatient programs for smoking cessation have the potential to produce sizeable reductions in cardiac events 1,3,4,6,7 and hospital costs. . . .
Fifteen years ago, routine smoking-cessation interventions for cardiac patients in hospital were deemed an "idea whose time has come," 40 but the interventions have not been widely adopted. The current trial contributes to the international evidence base and provides support to suggest that future research and practice should focus on dissemination of intensive interventions for smoking cessation into standard hospital practice for cardiac patients. The potential contributions to health and health care costs are substantial.
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