title: Smoking cessation may not improve quality of life in atherosclerotic patients.
abstract: The benefits of smoking cessation on patients' medical conditions are well documented. Cardiovascular patients who quit smoking significantly reduce their risk of a new event compared with those who continue smoking. Several studies have found that smoking is related to poor quality of life (QoL). In cardiovascular patients, however, less attention has been given to the effect of smoking cessation on patients' QoL. The present study examined the extent to which smoking cessation leads to changes in QoL in these patients within the first year of follow-up. Data were collected in the context of a randomized clinical trial. Smoking outpatients (N = 346) with atherosclerotic disease were included and received medical treatment. They were randomized to receive either nicotine replacement therapy (NRT) or NRT plus a behavioral intervention meant to promote smoking cessation. At baseline, sociodemographic and clinical characteristics were established. Generic and disease-specific QoL as well as smoking status were assessed at baseline and with three follow-up measurements. Multilevel modeling showed that generic and disease-specific QoL in atherosclerotic patients improved significantly within the first year of follow-up. No main differences were found between quitters and smokers in terms of improvement in QoL. In fact, some subgroups reported a poorer QoL after smoking cessation: More highly educated patients reported lower general QoL (p < .05), and patients suffering from coronary artery disease who had a low level of education (p < .01) and patients suffering from peripheral arterial disease who had low nicotine dependency (p < .01) reported lower disease-specific QoL. Atherosclerotic patients' QoL improved significantly but was not enhanced by smoking cessation activities.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Louise C W
authors.initials: LC
authors.lastname: Wiggers
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Oort
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.forename: Dink A
authors.initials: DA
authors.lastname: Legemate
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
authors.forename: Ellen M A
authors.initials: EM
authors.lastname: Smets
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000523:psychology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010555:Personality Inventory; D011788:Quality of Life / Q000523:psychology*; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000523:psychology* / Q000628:therapy*