High rates of sustained smoking cessation in women hospitalized with cardiovascular disease: the Women's Initiative for Nonsmoking (WINS).
BACKGROUND
Although men hospitalized with cardiovascular disease (CVD) show high smoking-cessation rates, similar data for women are lacking. We tested the efficacy of smoking-cessation intervention in women hospitalized for CVD.


RESULTS
In this randomized controlled trial conducted from 1996 to 2001, 277 women diagnosed with CVD (mean age 61+/-10 years) were randomly assigned within 1 of 12 San Francisco Bay Area hospitals to a usual-care group (UG; n=135) or intervention group (IG; n=142). Baseline histories were obtained, and interviews to ascertain self-reported smoking status occurred at 6, 12, 24, and 30 months after hospitalization. The UG received strong physician's advice, a self-help pamphlet, and a list of community resources. The IG received strong physician's advice and a nurse-managed cognitive behavioral relapse-prevention intervention at bedside, with telephone contact at intervals after discharge. The groups were similar demographically and had smoked cigarettes for a median of 38 (IG) or 40 (UG) years. Time to resumption of continuous smoking was assessed by Kaplan-Meier analysis, and risk differences between groups were determined. Time smoke-free was significantly greater for the IG than the UG (P=0.038). Point prevalence for nonsmoking at the interviews was somewhat greater for the IG than the UG (P>0.15 at all times).


CONCLUSIONS
Cognitive behavioral intervention resulted in longer average times to resumption of smoking, but in these 2 groups of older women with limited social and financial resources, long-term success rates were similar. Systematic identification of smokers and even the brief intervention afforded the UG yielded a high smoking-cessation rate over time.
Sivarajan Froelicher
Erika S
ES
University of California at San Francisco, Department of Physiological Nursing, School of Nursing, San Francisco, CA 94143-0610, USA. erika.froelicher@nursing.ucsf.edu
Miller
Nancy Houston
NH
Christopherson
Dianne J
DJ
Martin
Kirsten
K
Parker
Kathleen M
KM
Amonetti
Marcy
M
Lin
Zhen
Z
Sohn
Min
M
Benowitz
Neal
N
Taylor
C B
CB
Bacchetti
Peter
P
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D055502:Secondary Prevention; D016540:Smoking Cessation; D016019:Survival Analysis