Hospital counseling helps heart patients quit smoking
Smokers who suffer a heart attack may have better odds of kicking the habit if they get intensive counseling starting in the hospital, new research suggests.
In a study of smokers who were hospitalized for a heart attack or heart bypass surgery, those who were randomly assigned to an intensive smoking-cessation program were more likely to be abstinent one year later.
Compared with patients who received a nurse’s advice and some standard pamphlets while in the hospital, those in the intensive group were twice as likely to be tobacco-free after 1 year.
The smoking-cessation program began while patients were still in the hospital, with bedside counseling and advice. Patients then received take-home materials and phone-based counseling for 2 months after discharge.
The higher long-term quit rate suggests that the extra effort is worth the investment, the researchers report in the Canadian Medical Association Journal.
“By significantly increasing abstinence among cardiac patients, inpatient programs for smoking cessation have the potential to produce sizable reductions in cardiac events and hospital costs,” write the investigators, led by Dr. Patricia M. Smith of the Northern Ontario School of Medicine.
Experts have long called for hospitals to routinely offer heart patients smoking-cessation counseling, note Smith and her colleague Dr. Ellen Burgess. Such programs have not yet been widely adopted, however.
Smith and Burgess randomly assigned 276 heart patients at one hospital to receive either intensive smoking-cessation counseling or “minimal” advice.
After 12 months, 54 percent of patients in the intensive group were tobacco-free, based on reports from the patient and a family member or friend. That compared with 35 percent in the group that did not receive the intervention.
Patients in the intensive group were also twice as likely to be continuously abstinent during the 1-year follow-up.
“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,” Smith and Burgess write.
This, they add, suggests that immediate, in-hospital counseling is more likely to help heart patients than the typical approach of offering intensive counseling only when patients have quit and then relapsed.
SOURCE: Canadian Medical Association Journal
