title: Is There any Gender Difference for Smoking Persistence or Relapse Following Diagnosis or Hospitalization for Coronary Heart Disease? Evidence From a Systematic Review and Meta-Analysis.
abstract: Persistent smoking in patients diagnosed with coronary heart disease (CHD) has a significant effect on morbidity and mortality. Although there has been considerable debate around gender differences in smoking cessation, conclusive evidence on how gender impacts rates of smoking cessation and/or relapse following CHD diagnosis is lacking.
  
  
  
  Our aim was to test the hypothesis that female smokers with CHD were more likely to persist in smoking or relapse post-diagnosis or hospitalization than male smokers. We searched PubMed and Web of Science databases for studies published in the last 10 years. Meta-analyses were conducted using a random effects model.
  
  
  
  Sixteen studies met the inclusion criteria. The aggregated sample size was 36 591, 20 617 (56%) were smokers of which 2564 (12%) were female. Meta-analyses of eight studies where smoking prevalence could be measured, showed that females were less likely to be smokers at baseline than males (OR = 0.30, 95% CI = 0.13 to 0.70). Overall, one in two (47%) smokers persisted in smoking/relapsed following a diagnosis or hospitalization for CHD; but there was no gender difference in the rate of persistent smoking/relapse (OR = 1.07, 95% CI = 0.95 to 1.21).
  
  
  
  Female smokers with CHD were relatively uncommon in the included study populations. However, the rate of persistent smoking/relapse was high in both female and male smokers following a diagnosis or hospitalization for CHD. Therefore similar, sustained smoking cessation efforts are warranted for both genders.
  
  
  
  There was no gender difference for persistent smoking/relapse following a diagnosis or hospitalization for CHD, but the rate was high in both female and male smokers. Therefore, similar, sustained smoking cessation efforts are warranted for both genders.
authors.affiliation: Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Australia; Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Australia; aziz.rahman@y7mail.com drazizdmc@gmail.com.
authors.forename: Muhammad Aziz
authors.initials: MA
authors.lastname: Rahman
authors.affiliation: Nursing Research Unit St Vincent's Private Hospital Melbourne, Australian Catholic University, Melbourne, Australia;
authors.forename: Karen-Leigh
authors.initials: KL
authors.lastname: Edward
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Melbourne, Australia;
authors.forename: Laura
authors.initials: L
authors.lastname: Montgomery
authors.affiliation: St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Australia;
authors.forename: Samantha
authors.initials: S
authors.lastname: McEvedy
authors.affiliation: Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Health, Victorian Cardiology Clinical Network, Melbourne, Australia; Department of Cardiology, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilson
authors.affiliation: St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Australia; Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Australia; Her Heart Ltd, Melbourne, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Worrall-Carter
mesh_terms: D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*