Diagnosis of myocardial infarction was causally associated with a significant reduction in smoking, with adjusted OR 0.209 (95% CI 0.109-0.403; P<0.001) among initial smokers.
Does the diagnosis of myocardial infarction improve smoking cessation rates in initial smokers?
The diagnosis of myocardial infarction is causally associated with increased smoking cessation, likely driven by post-MI smoking interventions.
Absolute Event Rate: 0% vs 0%
Abstract Background Previous studies have demonstrated a strong link between smoking and myocardial infarction, emphasizing the importance of smoking cessation. However, the overall smoking rate remains high after the occurrence of myocardial infarction. Purpose To investigate the casual relationship between the diagnosis of myocardial infarction and smoking cessation. Methods A directed acyclic graph was structured to identify the confounding factors by reviewing the existing literature. The longitudinal cohort data from the China Health and Nutrition Survey was used to compare smoking status before and after the occurrence of myocardial infarction in the included population. Firstly, a likelihood ratio test was used to determine what kind of effect model should be employed. Then, logistic regression analysis with adjusted confounding factors was performed on panel data using STATA software to investigate the relationship of myocardial infarction diagnosis and smoking cessation on initial smokers. Finally, sensitivity analysis was performed to evaluate the stability of the results. Results Fifteen covariates and five causal pathways were confirmed ultimately to show the casual relationship in the directed acyclic graph. Subsequently, after applying inclusion and exclusion criteria, a total of 6789 individuals were included in the statistical analysis. Among them, 5345 were smokers and 1435 were non-smokers at the time of the first survey. Of the 5345 smokers at the first survey, 360 reported myocardial infarction 2-4 years later, with 71.7% (258/360) continuing to smoke. Among these initial smokers, compared with those who did not experience a myocardial infarction, the diagnosis of myocardial infarction was associated with a reduction in smoking. The differences were statistically significant regardless of whether variables were unadjusted (OR and 95%CI: 0.079, 0.061-0.102; P0.001), adjusted for gender and age (OR and 95%CI: 0.141, 0.107-0.185; P0.001), or further adjusted for ethnicity, body mass index, marital status, hypertension, diabetes, urban-rural residence, health insurance, and education (OR and 95%CI: 0.209, 0.109-0.403; P0.001). Conclusion A causal relationship exists between diagnosis of myocardial infarction and smoking cessation. This relationship comes more likely from smoking interventions.Directed acyclic graph Forest plot
Xu et al. (Sat,) reported a other. Diagnosis of myocardial infarction was causally associated with a significant reduction in smoking, with adjusted OR 0.209 (95% CI 0.109-0.403; P<0.001) among initial smokers.