title: A multifactorial smoking cessation programme for patients with coronary artery disease: experiences and preliminary results.
abstract: BACKGROUND
  Smoking is a known risk factor for coronary artery disease (CAD) and recurrent cardiac events in patients with established CAD. Although cessation can lead to a risk reduction of up to 50% following an initial myocardial infarction, at least 20% of cardiac patients continue to smoke.
  
  
  OBJECTIVE
  To describe and evaluate the effects of a comprehensive, multifactorial smoking cessation programme in outpatients with CAD, and to delineate variables that impede smoking cessation.
  
  
  METHODS
  Patients with a confirmed diagnosis of CAD recruited from the outpatient cardiology clinic, Dijkzigt University Hospital, Rotterdam, participated in the cessation programme and were followed for three months. Endpoint was smoking cessation.
  
  
  METHODS
  Purpose-designed and validated questionnaires were used to assess smoking history, sociodemographic and psychological parameters. Information on cardiac history was sampled from medical records. Height and blood pressure were measured at baseline, and weight and expiratory CO at every group session of the cessation programme.
  
  
  RESULTS
  One third of the patients recruited for the programme achieved cessation at three months. Quitters generally smoked less, were less addicted, scored lower on anxiety and depression, and had more recently been diagnosed with CAD. Type D personality was an impediment to cessation (OR:3.50; 95% CI: 0.40-35.48).
  
  
  CONCLUSIONS
  Thirty-two percent of the patients achieved cessation at three months. Cessation efforts should be started in-hospital or as early as possible following diagnosis. An interdisciplinary and multifactorial approach seems warranted, in particular given the negative influence of anxiety, depression, and Type D personality on cessation.
authors.forename: S S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: J W
authors.initials: JW
authors.lastname: Deckers
authors.forename: F
authors.initials: F
authors.lastname: van Os
authors.forename: R A M
authors.initials: RA
authors.lastname: Erdman
keywords: Type D personality; coronary artery disease; intervention; smoking cessation programme