Hospital-based programs seem to help smokers quit

By Joene Hendry

NEW YORK (Reuters Health) - After suffering a heart attack, smokers appear much more likely to stop smoking if they participated in a hospital-based smoking cessation program or if they are referred to cardiac rehabilitation upon discharge, study findings suggest.

"Simply advising heart attack patients to quit smoking prior to hospital discharge does not appear to impact smoking cessation," Dr. Susmita Parashar told Reuters Health.

Parashar, of Emory University School of Medicine in Atlanta, and colleagues assessed the smoking behavior of 2498 men and women admitted for a heart attack at one of 19 U.S. hospitals between January 2003 and June 2004. Of these individuals 834 smoked at the time of hospitalization, the investigators report in the Archives of Internal Medicine.

Six months after discharge the results of a telephone survey of 639 patients revealed that just 297 (46 percent) had stopped smoking. Most of the patients were male (69 percent) and an average of 54 years old.

The researchers found that a history of cocaine use and significant signs of depression were patient characteristics associated with continued smoking.

Parashar's group also noted that about the same percentage of those who quit and those who were still smoking had been individually counseled to quit smoking when discharged from the hospital.

By contrast, 69 percent of those who quit, compared with 56 percent of still smokers, had been hospitalized in facilities with smoking cessation programs. Likewise, 63 percent of former smokers, compared with 47 percent of still smokers, had been referred to cardiac rehabilitation, programs that traditionally encourage smoking cessation.

These findings highlight the need for hospitals to focus on more structured programs, such as hospital-based smoking cessation and cardiac rehabilitation, to improve quit rates among smokers who have suffered a heart attack, Parashar said. Treatment for depression in these patients should also be considered.

SOURCE: Archives of Internal Medicine, October 2008.