title: Cognitive changes in cardiovascular patients following a tailored behavioral smoking cessation intervention.
abstract: BACKGROUND
  Action aimed at changing smoking behavior to prevent cardiovascular patients from further impairing their health is advisable. Cognitive behavioral interventions can be effective in this regard since they attempt to influence cognitive determinants that presumably lead to smoking cessation. The Minimal Intervention Strategy for Cardiology patients (C-MIS) is such an intervention, tailored to the patients' readiness to change. Our aim is to investigate whether the C-MIS is successful in changing patients' cognitions such as attitudes, social influence, self-efficacy and intention to quit during a 1-year period.
  
  
  METHODS
  Smoking outpatients (N = 315) with cardiovascular disease were included. They were randomized and received either Nicotine Replacement Therapy (NRT) or NRT + C-MIS. At baseline (T1), sociodemographic and clinical characteristics were measured. Cognitions and quitting behavior were assessed at baseline and at four follow-up measurements.
  
  
  RESULTS
  Comparing treatments, the C-MIS did not affect pros of quitting, pros of smoking and social influence. We did find small effects of the C-MIS on intention to quit and self-efficacy, although only for higher-educated patients.
  
  
  CONCLUSIONS
  The C-MIS appears successful in affecting intention to quit and self-efficacy abilities, but only for patients with higher education levels. Initial positive changes in cognitions may also emerge in a medical intervention, such as the provision of NRT.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
authors.forename: L C W
authors.initials: LC
authors.lastname: Wiggers
authors.forename: F J
authors.initials: FJ
authors.lastname: Oort
authors.forename: A
authors.initials: A
authors.lastname: Dijkstra
authors.forename: J C J M
authors.initials: JC
authors.lastname: de Haes
authors.forename: D A
authors.initials: DA
authors.lastname: Legemate
authors.forename: E M A
authors.initials: EM
authors.lastname: Smets
mesh_terms: D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D001294:Attitude to Health; D001521:Behavior Therapy / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009538:Nicotine / Q000008:administration & dosage*; D012016:Reference Values; D012307:Risk Factors; D020377:Self Efficacy; D012737:Sex Factors; D012907:Smoking / Q000523:psychology* / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D009538:Nicotine