Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-13T12:02:13.713Z Has data issue: false hasContentIssue false
  • English
  • Français

A Retrospective Review of Pilot Outcomes from an Out-patient Tobacco Treatment Programme Within Cardiology Services

Published online by Cambridge University Press:  24 January 2014

Milan Khara  and
Chizimuzo T.C. Okoli
Milan Khara
Affiliation:
Vancouver General Hospital Smoking Cessation Clinic
Chizimuzo T.C. Okoli*
Affiliation:
University of Kentucky College of Nursing
*
Address for correspondence: Chizimuzo T.C. Okoli, Assistant Professor and Director, Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536-0232, Email: ctokol1@uky.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction: Due to the challenging nature of tobacco addiction, individuals with cardiac conditions often continue to smoke at high rates (up to 62%), even after experiencing life-threatening events.

Aims: This study examines pilot outcomes of a longitudinal Smoking Cessation Clinic (SCC) within cardiology services.

Methods: This study is based on a retrospective review of the charts of 117 participants of the SCC (between September 2010 and May 2012). The main outcome of interest is self-reported 7-day point-prevalence of smoking abstinence verified by expired CO level. A secondary outcome was smoking reduction, defined as consuming 50% (or lower) than the baseline number cigarettes in the past week.

Results: Thirty-five per cent of participants achieved smoking cessation, whereas 42.1% reduced their cigarette consumption. In multivariate regression analyses, salient predictors of smoking cessation included being male and a greater length of visiting the smoking cessation clinic.

Conclusions: Providing evidence-based approaches to tobacco treatment within cardiology services is feasible and well received by patients with cardiac and other co-morbidity. The modest outcomes from this pilot study support the need for tobacco treatment in hospital cardiology settings. Such interventions may aid in reducing the disproportionate burden of tobacco-related disease among smokers with medical co-morbidity.

Keywords

Smoking cessationevidence-based treatmentcardiologymedical co-morbidity
Type
Articles
Information
Journal of Smoking Cessation , Volume 10 , Issue 1 , June 2015 , pp. 74 - 84
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bader, P., McDonald, P., & Selby, P. (2009). An algorithm for tailoring pharmacotherapy for smoking cessation: results from a Delphi panel of international experts. Tobacco Control, 18 (1), 34–42. doi: 10.1136/tc.2008.025635Google Scholar
Chan, S. S. C., Leung, D. Y. P., Wong, D. C. N., Lau, C.-P., Wong, V. T., & Lam, T.-H. (2012). A randomized controlled trial of stage-matched intervention for smoking cessation in cardiac out-patients. Addiction, 107 (4), 829–837. doi: 10.1111/j.1360-0443.2011.03733.xGoogle Scholar
Colivicchi, F., Mocini, D., Tubaro, M., Aiello, A., Clavario, P., & Santini, M. (2011). Effect of smoking relapse on outcome after acute coronary syndromes. The American Journal of Cardiology, 108 (6), 804–808. doi: 10.1016/j.amjcard.2011.04.033CrossRefGoogle ScholarPubMed
DiClemente, C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting Clinical Psychology, 59 (2), 295–304.Google Scholar
Feenstra, T. L., Hamberg-van Reenen, H. H., Hoogenveen, R. T., & Rutten-van Mölken, M. P. (2005). Cost-effectiveness of face-to-face smoking cessation interventions: a dynamic modeling study. Value in Health, 8 (3), 178–190. doi: http://dx.doi.org/10.1111/j.1524–4733.2005.04008.xCrossRefGoogle Scholar
Fiore, M., Jaén, C., Baker, T., Bailey, W., Benowitz, N., Curry, S., . . . Leitzke, C. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. .Google Scholar
Gerber, Y., Koren-Morag, N., Myers, V., Benyamini, Y., Goldbourt, U., & Drory, Y. (2011). Long-term predictors of smoking cessation in a cohort of myocardial infarction survivors: a longitudinal study. European Journal of Cardiovascular Prevention & Rehabilitation, 18 (3), 533–541. doi: 10.1177/1741826710389371CrossRefGoogle Scholar
Gerber, Y., Rosen, L. J., Goldbourt, U., Benyamini, Y., & Drory, Y. (2009). Smoking status and long-term survival after first acute myocardial infarction: a population-based cohort study. Journal of the American College of Cardiology, 54 (25), 2382–2387. doi: 10.1016/j.jacc.2009.09.020Google Scholar
Glasgow, R. E., Tracy Orleans, C., Wagner, E. H., Curry, S. J., & Solberg, L. I. (2001). Does the chronic care model serve also as a template for improving prevention? Milbank Quarterly, 79 (4), 579–612. doi: 10.1111/1468-0009.00222CrossRefGoogle ScholarPubMed
Godtfredsen, N. S., Osler, M., Vestbo, J., Andersen, I., & Prescott, E. (2003). Smoking reduction, smoking cessation, and incidence of fatal and non-fatal myocardial infarction in Denmark 1976–1998: a pooled cohort study. Journal of Epidemiology and Community Health, 57 (6), 412–416. doi: 10.1136/jech.57.6.412Google Scholar
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86 (9), 1119–1127. doi: 10.1111/j.1360-0443.1991.tb01879.xGoogle Scholar
Hevey, D., Slack, K., Cahill, A., Newton, H., & Horgan, J. H. (2002). Rates of smoking in the households of cardiac patients. Journal of Cardiovascular Risk, 9 (5), 271–274. doi: 10.1177/174182670200900507Google Scholar
Hosmer, D., & Lemeshow, S. (2000). Applied Logistic Regression (2nd ed.). New York: Wiley.Google Scholar
Hughes, J. R., Carpenter, M. J., & Naud, S. (2010). Do point prevalence and prolonged abstinence measures produce similar results in smoking cessation studies? A systematic review. Nicotine & Tobacco Research, 12 (7), 756–762. doi: 10.1093/ntr/ntq078CrossRefGoogle ScholarPubMed
Kahler, C. W., LaChance, H. R., Strong, D. R., Ramsey, S. E., Monti, P. M., & Brown, R. A. (2007). The commitment to quitting smoking scale: Initial validation in a smoking cessation trial for heavy social drinkers. Addictive Behaviors, 32 (10), 2420–2424. doi: 10.1016/j.addbeh.2007.04.002Google Scholar
Khara, M., & Okoli, C. T. C. (2011). The Tobacco-Dependence Clinic: Intensive tobacco-dependence treatment in an addiction services outpatient setting. The American Journal on Addictions, 20 (1), 45–55. doi: 10.1111/j.1521-0391.2010.00096.xCrossRefGoogle Scholar
Kinjo, K., Sato, H., Sakata, Y., Nakatani, D., Mizuno, H., Shimizu, M., . . . on Behalf of the Osaka Acute Coronary Insufficiency Study, G. (2005). Impact of smoking status on long-term mortality in patients with acute myocardial infarction. Circulation Journal, 69 (1), 7–12.Google Scholar
Marlatt, G. A., Curry, S., & Gordon, J. R. (1988). A longitudinal analysis of unaided smoking cessation. Journal of Consulting & Clinical Psychology, 56 (5), 715–720.Google Scholar
Middleton, E. T., & Morice, A. H. (2000). Breath carbon monoxide as an indication of smoking Habit. Chest, 117 (3), 758–763. doi: 10.1378/chest.117.3.758Google Scholar
Mohiuddin, S. M., Mooss, A. N., Hunter, C. B., Grollmes, T. L., Cloutier, D. A., & Hilleman, D. E. (2007). Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest, 131 (2), 446–452. doi: 10.1378/chest.06-1587Google Scholar
Public Health Agency of Canada. (2007). Life and Breath: Respiratory Disease in Canda. Ottawa: Public Health Agency of Canada.Google Scholar
Raw, M., Regan, S., Rigotti, N. A., & McNeill, A. (2009). A survey of tobacco dependence treatment services in 36 countries. Addiction, 104 (2), 279–287. doi: 10.1111/j.1360-0443.2008.02443.xCrossRefGoogle ScholarPubMed
Rea, T. D., Heckbert, S. R., Kaplan, R. C., Smith, N. L., Lemaitre, R. N., & Psaty, B. M. (2002). Smoking status and risk for recurrent coronary events after myocardial infarction. Annals of Internal Medicine, 137 (6), 494–500.CrossRefGoogle ScholarPubMed
Samaan, Z., Nowacki, B., Schulze, K., Magloire, P., & Anand, S. (2012). Smoking cessation intervention in a cardiovascular hospital based clinical setting. Cardivascular Psychiatry and Neurology, 7. Retrieved from doi:10.1155/2012/970108Google Scholar
Selby, P., Voci, S. C., Zawertailo, L. A., George, T. P., & Brands, B. (2010). Individualized smoking cessation treatment in an outpatient setting: Predictors of outcome in a sample with psychiatric and addictions co-morbidity. Addictive Behaviors, 35 (9), 811–817. doi: http://dx.doi.org/10.1016/j.addbeh.2010.03.020Google Scholar
Tverdal, A., & Bjartveit, K. (2006). Health consequences of reduced daily cigarette consumption. Tobacco Control, 15 (6), 472–480. doi: 10.1136/tc.2006.016246CrossRefGoogle ScholarPubMed
U.S. Department of Health and Human Services. (2010). How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.Google Scholar
Van Berkel, T. F. M., Boersma, H., Roos-Hesselink, J. W., Erdman, R. A. M., & Simoons, M. L. (1999). Impact of smoking cessation and smoking interventions in patients with coronary heart disease. European Heart Journal, 20 (24), 1773–1782. doi: 10.1053/euhj.1999.1658Google Scholar
Van Spall, H. G. C., Chong, A., & Tu, J. V. (2007). Inpatient smoking-cessation counseling and all-cause mortality in patients with acute myocardial infarction. American Heart Journal, 154 (2), 213–220. doi: 10.1016/j.ahj.2007.04.012Google Scholar
West, R., Hajek, P., Stead, L., & Stapleton, J. (2005). Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction, 100 (3), 299–303. doi: 10.1111/j.1360-0443.2004.00995.xGoogle Scholar
Wilson, K., Gibson, N., Willan, A., & Cook, D. (2000). Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med, 160 (7), 939–944. doi: 10.1001/archinte.160.7.939Google Scholar