Role of smokers in the household and of cardiac rehabilitation in smoking behaviour after acute myocardial infarction.
OBJECTIVE
This study aims to evaluate the influence of household smokers and of a prolonged, comprehensive home-based Cardiac Rehabilitation Program (CRP) on patient's long term smoking behaviour after AMI.


METHODS
164 male post-AMI patients, all smokers until the day of AMI, were subdivided into three groups: Group A (n=54): patients with recent AMI, discharged from hospital without enrolment in CRP; Group B (n=55): similar to Group A but enrolled in an 8 weeks hospital-based CRP and then discharged home with routine care; Group C (n=55) enrolled in an 8 weeks hospital-based CRP followed by a further 10 months of formal home-based CRP, with scheduled hospital follow-up visits.


RESULTS
Smoking resumption at 12 months was influenced by the presence of household smokers (HS): 38% of patients with HS resumed smoking compared to 27% of patients without HS (p <0.01). Adherence to a CRP was inversely correlated to smoking resumption: there were fewer smoking patients at 12 months from AMI in Group C than in Groups A or B (11% in C vs. 29% and 55% in B and A, respectively, p <0.001).


CONCLUSIONS
Long term maintenance of CRP seems to be the best way to achieve a reduction of long term smoking habit and maintain adherence to prescription in patients after AMI. Counselling and behavioural intervention should also be extended to family members in order to maximize the benefit of secondary prevention.
Giallauria
Francesco
F
Department of Clinical Medicine, Cardiovascular and Immunological Science, University of Naples Federico II, via S. Pansini 5, 1-80131 Napoli, Italy.
Paragliola
Teresa
T
Pilerci
Francesco
F
Del Forno
Domenico
D
De Lorenzo
Anna
A
Manakos
Athanasio
A
Lucci
Rosa
R
Psaroudaki
Marianna
M
D'Agostino
Mariantonietta
M
Vigorito
Carlo
C
D000368:Aged; D001521:Behavior Therapy; D016009:Chi-Square Distribution; D003376:Counseling; D003627:Data Interpretation, Statistical; D015444:Exercise; D005191:Family Characteristics; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control / Q000534:rehabilitation*; D009679:Nuclear Family; D010349:Patient Compliance; D012046:Rehabilitation; D012307:Risk Factors; D012907:Smoking; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013997:Time Factors