Aversive advice delivered during percutaneous coronary intervention significantly increased the 24-week smoking cessation rate compared to usual care in patients with acute coronary syndrome (OR 4.47).
RCT (n=66)
Single-blind
Computer-generated randomization list
No
Does aversive advice during PCI improve smoking cessation rates in patients with acute coronary syndrome?
Aversive advice delivered by a physician during PCI significantly improves smoking cessation rates at 24 weeks in patients with ACS.
Effect estimate: OR 4.47 (95% CI 1.50-13.34)
Absolute Event Rate: 66.7% vs 30.3%
p-value: p=0.007
BACKGROUND: Smoking cessation is important to prevent recurrence of acute coronary syndrome (ACS), but even in patients with ACS, smoking is hard to quit. OBJECTIVES: This study hypothesized that aversive advice during the percutaneous coronary intervention (PCI) procedure works effectively to promote smoking cessation in patients with ACS. METHODS: This study was conducted as a prospective, single-blinded, randomized controlled trial. A total of 66 patients were randomly assigned to an aversive advice group or a control group and instructed to visit the outpatient clinic 1, 4, and 24 weeks after discharge. In the aversive advice group, a physician who did not participate in the patient follow-up said the following 3 sentences to the patients during the PCI procedure: "Smoking caused your chest pain"; "If you do not stop smoking right now, this pain will come again"; and "The next time you feel this pain you will probably die." All patients received usual advice on the importance of quitting smoking. RESULTS: At 24 weeks after discharge, the smoking cessation rate was higher in the aversive advice group than in the control group. In a multivariable logistic regression analysis, after adjustment for age, smoking quantity, alcohol consumption, and disease severity, the result was maintained (odds ratio = 4.47, 95% confidence interval: 1.50 to 13.34). CONCLUSIONS: Aversive advice during a PCI procedure is effective at smoking cessation in patients with ACS. A physician's attention and involvement during the PCI procedure improves the rate of smoking cessation in patients with ACS.
Kim et al. (Wed,) conducted a rct in Acute Coronary Syndrome (n=66). Aversive advice during PCI vs. Usual advice was evaluated on Smoking cessation rate at 24 weeks after discharge (OR 4.47, 95% CI 1.50-13.34, p=0.007). Aversive advice delivered during percutaneous coronary intervention significantly increased the 24-week smoking cessation rate compared to usual care in patients with acute coronary syndrome (OR 4.47).