Characteristics of smokers and long-term changes in smoking behavior in consecutive patients with myocardial infarction.
BACKGROUND
The prognosis of patients with estabLished coronary artery improves if smoking is stopped. Still, about half of patients who suffer a myocardial infarction continue smoking after that event. In order to predict to whom additional support should be offered, various baseline characteristics were compared with smoking status at short-term and long-term follow-up.


METHODS
Demographics, medical history, presence of coronary risk factors, psychological determinants, and the clinical course were recorded in a group of 530 unselected consecutive patients who had been admitted with a myocardial infarction and were smoking. Patients who were smoking at admission, and who were alive at 4-year follow-up, were studied to relate smoking status and baseline characteristics.


RESULTS
At 3 months, persistent smokers were younger than quitters, had shorter hospital stays, underwent revascularization procedures less often, smoked more cigarettes per day at baseline, and were more socially isolated. After 4 years, patients who stopped smoking had had a more serious myocardial infarction and had a lower displeasure score than those who continued smoking. Also, quitters received more support from their social environment.


CONCLUSIONS
Although the majority of the patients try to stop smoking after a myocardial infarction, about half smokes after 4 years. In the future, special support should be offered to smokers who suffer myocardial infarction, especially to those whose psychosocial profiles are less favorable.
van Berkel
T F
TF
Thoraxcenter, University Hospital Rotterdam, The Netherlands. vanberkel@card.azr.nl
van der Vlugt
M J
MJ
Boersma
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000517:prevention & control*; D009664:Norway / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012016:Reference Values; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric; D015996:Survival Rate