title: Smoking cessation after an acute coronary syndrome: immediate quitters are successful quitters.
abstract: BACKGROUND
  Cardiovascular disease (CVD) prevention guidelines stress the importance of smoking cessation and recommend intensive follow-up. To guide the development of such cessation support strategies, we analysed the characteristics that are associated with successful smoking cessation after an acute coronary syndrome (ACS).
  
  
  METHODS
  We used data from the Randomised Evaluation of Secondary Prevention for ACS patients coordinated by Outpatient Nurse SpEcialists (RESPONSE) trial (n = 754). This was designed to quantify the impact of a nurse-coordinated prevention program, focusing on healthy lifestyles, traditional CVD risk factors and medication adherence. For the current analysis we included all smokers (324/754, 43 %). Successful quitters were defined as those who reported abstinence at 1 year of follow-up.
  
  
  RESULTS
  The majority of successful quitters quit immediately after the ACS event and remained abstinent through 1 year of follow-up, without extra support (128/156, 82 %). Higher education level (33 vs. 15 %, p < 0.01), no history of CVD (87 vs. 74 %, p < 0.01) and being on target for LDL-cholesterol level at 1 year (78 vs. 63 %, p < 0.01) were associated with successful quitting.
  
  
  CONCLUSIONS
  The majority of successful quitters at 1 year stopped immediately after their ACS. Patients in this group showed that it was within their own ability to quit, and they did not relapse through 1 year of follow-up. Our study indicates that in a large group of patients who quit immediately after a life-threatening event, no relapse prevention program is needed.
authors.affiliation: University of Applied Sciences, Hogeschool van Amsterdam, Amsterdam School of Health Professions, Tafelbergweg 51, 1105 BD, Amsterdam, The Netherlands. m.snaterse@hva.nl.
authors.forename: M
authors.initials: M
authors.lastname: Snaterse
authors.affiliation: University of Applied Sciences, Hogeschool van Amsterdam, Amsterdam School of Health Professions, Tafelbergweg 51, 1105 BD, Amsterdam, The Netherlands.
authors.forename: W J M
authors.initials: WJ
authors.lastname: Scholte Op Reimer
authors.affiliation: University of Applied Sciences, Hogeschool van Amsterdam, Amsterdam School of Health Professions, Tafelbergweg 51, 1105 BD, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Dobber
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Minneboo
authors.affiliation: Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Ter Riet
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: H T
authors.initials: HT
authors.lastname: Jorstad
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Boekholdt
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: R J G
authors.initials: RJ
authors.lastname: Peters
keywords: Acute coronary syndrome; Secondary prevention; Smoking cessation