title: Readiness for smoking cessation in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey.
abstract: BACKGROUND
  Readiness for smoking cessation is an important predictor of quit attempts and cessation success. We aimed to investigate the prevalence and correlates of readiness for smoking cessation in coronary heart disease (CHD) patients.
  
  
  METHODS
  The EUROpean Action on Secondary and Primary Prevention by Intervention to Reduce Events III (EUROASPIRE III) survey is a cross-sectional study conducted in 2006-2007 among CHD patients <80 years of age from 22 European regions.
  
  
  METHODS
  Patients were interviewed on average 15 months after hospital admission for an acute coronary event or procedure. Readiness for smoking cessation was assessed using the smoking stages of change (SSC) short form questionnaire. Breath carbon monoxide was measured to validate self-reported non-smoking.
  
  
  RESULTS
  Among 2585 patients who were smoking prior to hospital admission, 25.6%, 16.8%, 8.1%, 5.6% and 44.0% were in the precontemplation (no intention to quit), contemplation (thinking of quitting), preparation (planning to quit), action (having quit within six months) and maintenance (having quit more than six months ago) stages, respectively. Significant multivariable correlates of advancement in SSC showed positive associations of older age and attended cardiac rehabilitation and negative associations of severe depressive symptoms, longer smoking duration and environmental tobacco smoke (ETS) exposure.
  
  
  CONCLUSIONS
  One-quarter of CHD patients across Europe who were smoking prior to hospitalisation have no intention to quit, and an additional quarter is thinking of quitting or planning to quit. Patients who are younger, do not attend cardiac rehabilitation, have severe depressive symptoms, have been smoking for longer periods of time and are exposed to ETS may need to be specifically targeted in cessation interventions.
authors.affiliation: INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France christof.prugger@inserm.fr.
authors.forename: Christof
authors.initials: C
authors.lastname: Prugger
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wellmann
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Germany Epidemiological Cancer Registry North Rhine-Westphalia, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Heidrich
authors.affiliation: Department of Public Health, University of Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.affiliation: Department of Public Health, University of Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.affiliation: INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Périer
authors.affiliation: INSERM, Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
authors.affiliation: Department of Internal Medicine, University of Zagreb, Croatia.
authors.forename: Željko
authors.initials: Ž
authors.lastname: Reiner
authors.affiliation: Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Fras
authors.affiliation: Cardiovascular Medicine, Imperial College London, UK.
authors.forename: Catriona
authors.initials: C
authors.lastname: Jennings
authors.affiliation: Cardiovascular Medicine, Imperial College London, UK.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: Cardiovascular Medicine, Imperial College London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wood
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
mesh_terms: D000367:Age Factors; D000368:Aged; D001944:Breath Tests; D002248:Carbon Monoxide / Q000032:analysis; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010349:Patient Compliance; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D002248:Carbon Monoxide
keywords: Stages of change; coronary artery disease; epidemiology; smoking cessation