A randomized controlled trial of smoking cessation counseling after myocardial infarction.
BACKGROUND
Smoking cessation after myocardial infarction (MI) has been associated with a 50% reduction in mortality but in-hospital smoking cessation interventions are rarely part of routine clinical practice.


METHODS
One hundred cigarette smokers consecutively admitted during 1996 with MI were assigned to minimal care or to a hospital-based smoking cessation program. Intervention consisted of bedside cessation counseling followed by seven telephone calls over the 6 months following discharge. Primary outcomes were abstinence rates measured at 6 months and 1 year post-discharge.


RESULTS
At follow-up, 43 and 34% of participants in minimal care and 67 and 55% of participants in intervention were abstinent at 6 and 12 months. respectively (P<0.05). Abstinence rates were calculated assuming that participants lost to attrition were smokers at follow-up. Intervention and self-efficacy were independent predictors of smoking status at follow-up. Low self-efficacy combined with no intervention resulted in a 93% relapse rate by 1 year (P<0.01).


CONCLUSIONS
A hospital-based smoking cessation program consisting of inpatient counseling and telephone follow-up substantially increases smoking abstinence 1 year after discharge in patients post-MI. Patients with low self-efficacy are almost certain to relapse without intervention. Such smoking cessation programs should be part of the management of patients with MI.
Dornelas
E A
EA
Hartford Hospital, Hartford, Connecticut, 06102, USA. edornel@harthosp.org
Sampson
R A
RA
Gray
J F
JF
Waters
D
D
Thompson
P D
PD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications*; D010349:Patient Compliance; D018570:Risk Assessment; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D014029:Tobacco Use Disorder / Q000150:complications* / Q000534:rehabilitation*