title: Predictors of smoking cessation and relapse after hospitalization for acute coronary syndrome.
abstract: BACKGROUND
  A hospital admission for a serious cardiac event offers a unique opportunity for smoking cessation. Understanding the factors that predict and enhance cessation among smoking cardiac inpatients is important for hospital physicians and clinical staff.
  
  
  OBJECTIVE
  To determine factors that predict smoking cessation, relapse, or continued smoking among posthospitalized cardiac patients who were smoking at the time of admission.
  
  
  METHODS
  Patients hospitalized with acute coronary syndrome (ACS) were recruited from 5 hospitals in Michigan to participate in a study assessing hospital quality improvement plus at-home health behavior change counseling.
  
  
  METHODS
  Patient interview data were collected shortly after discharge and 3 and 8 months later to describe patient demographics, clinical characteristics, tobacco use, and other behaviors. Multinomial logit regression was used to predict smoking cessation, relapse, and continued smoking.
  
  
  RESULTS
  Of patients smoking at hospitalization who completed both follow-up interviews, 56.8% (n = 111) were not smoking at 8 months. A significant predictor of successful cessation was higher household income (odds ratio [OR] = 4.72; P = 0.003), while having other smokers in the household decreased the odds of cessation (OR = 0.20; P = 0.001). History of depression increased the odds of relapse (OR = 6.38; P = 0.002) and being a lighter smoker decreased the odds (OR = 0.16; P = 0.026).
  
  
  CONCLUSIONS
  Although approximately one-half of the smokers in this study reported successful cessation, interventions are still needed to assist all smokers to successfully quit smoking after an ACS hospitalization. Our data suggest targeting follow-up programs to include other family members and using specialized methods for heavy smokers.
authors.affiliation: Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan 48824, USA. jodi.holtrop@hc.msu.edu
authors.forename: Jodi Summers
authors.initials: JS
authors.lastname: Holtrop
authors.forename: Manfred
authors.initials: M
authors.lastname: Stommel
authors.forename: William
authors.initials: W
authors.lastname: Corser
authors.forename: Margaret
authors.initials: M
authors.lastname: Holmes-Rovner
mesh_terms: D054058:Acute Coronary Syndrome; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010351:Patient Discharge; D012008:Recurrence; D016540:Smoking Cessation; D000074606:Smoking Prevention