The effectiveness of a nursing inpatient smoking cessation program in individuals with cardiovascular disease.
BACKGROUND
Smoking is an important risk factor for cardiovascular disease (CVD), and quitting is highly beneficial. Yet, less than 30% of CVD patients stop smoking. Relapse-prevention strategies seem most effective when initiated during the exacerbation of the disease.


OBJECTIVE
A nurse-delivered inpatient smoking cessation program based on the Transtheoretical Model with telephone follow-up tailored to levels of readiness to quit smoking was evaluated on smoking abstinence and progress to ulterior stages of change.


METHODS
Participants (N = 168) were randomly assigned by cohorts to inpatient counseling with telephone follow-up, inpatient counseling, and usual care. The inpatient intervention consisted of a 1-hr counseling session, and the telephone follow-up included 6 calls during the first 2 months after discharge. The nursing intervention was tailored to the individual's stage of change. End points at 2 and 6 months included actual and continuous smoking cessation rates (biochemical markers) and increased motivation (progress to ulterior stages of change).


RESULTS
Assuming that surviving patients lost to follow-up were smokers, the 6-month smoking abstinence rate was 41.5% in the inpatient counseling with telephone follow-up group, compared with 30.2% and 20% in the inpatient counseling and usual care groups, respectively (p = .05). Progress to ulterior stages of change was 43.3%, 32.1%, and 18.2%, respectively (p = .02). Stage of change at baseline and intervention predicted smoking status at 6 months.


CONCLUSIONS
This tailored smoking cessation program with telephone follow-up significantly increased smoking cessation at 6 months, and progression to ulterior stages of change. The telephone follow-up was an important adjunct. It is, therefore, recommended to include such comprehensive smoking cessation programs within hospital settings for individuals with CVD.
Chouinard
Maud-Christine
MC
Module des sciences infirmières et de la santé, Université du Québec à Chicoutimi, Québec, Canada. maud-christine_chuinard@uqac.ca
Robichaud-Ekstrand
Sylvie
S
D000359:Aftercare / Q000379:methods / Q000523:psychology; D000704:Analysis of Variance; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000150:complications*; D016009:Chi-Square Distribution; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007297:Inpatients / Q000193:education* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D015403:Nursing Evaluation Research; D015397:Program Evaluation; D011792:Quebec; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention