title: Change in smoking habits after having been screened for abdominal aortic aneurysm.
abstract: OBJECTIVE
  To study smoking habits among men with abdominal aortic aneurysm at screening at 65 years of age, and during follow-up, as a base-line study to evaluate future interventions.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Between 2006 and 2011, 8150 65-year-old men (compliance 85%) were screened for AAA in Uppsala County, Sweden. Among 292 men with an aortic diameter of at least 25 mm, 77 were active smokers at the time of screening. At follow-up of smoking habits in 2012, 53 men (69%) participated in this study, 28 had an AAA of at least 30 mm and 25 a sub-aneurysmal aorta (SAA) 25-29 mm at baseline. For each case, one control was randomly selected, all active smokers with aortic diameter less than 25 mm at baseline, matched for age and year of screening. Telephone interviews were performed at a median 34 months (range: 4-67) after screening.
  
  
  RESULTS
  Men with AAA had hypertension more often than controls (68% vs. 23%, p < .001). Men with AAA and SAA reported more smoking years than controls (p = .017). Cessation rate among patients with AAA did not differ significantly compared with men with an aorta less than 30 mm (29% vs. 15%, p = .159), but they had reduced their consumption of cigarettes/day significantly more than men with SAA and controls (-8.2 vs. -3.0 vs. -4.5, p = .030). Men with AAA recalled having been informed about the importance of smoking cessation at the time of screening more often (p = .031). There was no difference in growth of the AAA between those who continued, and those who quit smoking (2.03 vs. 2.01 mm/year, p = .982), but the study was not powered to study AAA growth.
  
  
  CONCLUSIONS
  Although counselling in a normal healthcare setting had some effect, the results indicate a need to tailor interventions to further increase smoking cessation rates among men diagnosed with both AAA and SAA.
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Bohlin
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Fröjd
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Wanhainen
authors.affiliation: Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden. Electronic address: martin@bjorck.pp.se.
authors.forename: M
authors.initials: M
authors.lastname: Björck
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D003376:Counseling; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013548:Sweden / Q000453:epidemiology
keywords: Abdominal aortic aneurysm; Case–control study; Risk factor; Screening; Smoking cessation; Sub-aneurysmal aorta