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May 9, 2026

Tobacco and Nicotine Consumption and the Motivation to Stop Smoking in Smokers With and Without Coronary Heart Disease: A Comparative Analysis of Two Cross-Sectional Studies.

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Key result

CHD is linked to lower smoking rates but ~190% more quit attempts versus no CHD.

  • n=11,069

Why the study?

Smoking worsens the prognosis of patients with CHD, but limited population-based data exist regarding smoking cessation and its characteristics in this population.

Does having coronary heart disease affect tobacco dependence, motivation to quit, and quit attempts among adult smokers?

Population

11 069 adults aged 35 years and above in Germany

Comparison

People with CHD vs people without CHD

Design

Pooled analysis of two representative cross-sectional surveys

Authors

SKStephanie KlosterhalfenDüsseldorf University HospitalSHSabrina HoppeDKDaniel Kotz

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Implication

Caution needed interpreting e-product use in CHD smokers as cessation; leaves open net CV safety, requiring prospective trials.

Key Points

  • This research aims to explore the differences in smoking behavior and motivation to quit between smokers with and without coronary heart disease (CHD).
  • Analyzed pooled data from two cross-sectional surveys (DEBRA and OptiCor) covering 11,069 adults aged 35 and above.
  • Included smoking behavior, dependence, attempts to quit, and use of electronic inhalation products as endpoints.
  • Applied regression models adjusting for age, sex, education, and income with CHD as an independent variable.
  • Smokers with CHD had lower smoking rates (23.8%) compared to non-CHD smokers (29.3%) but higher former smoker rates (32.2% vs. 18.9%).
  • CHD smokers showed increased use of electronic inhalation products (OR=2.53), higher motivation to quit (OR=1.41), and greater tobacco dependence (OR=1.63).
  • Among current smokers, those with CHD were more likely to attempt quitting within the past year (OR=2.90).

Study Design

Type

Cross-Sectional (n=11,069)

Multicenter

Yes

Structured PICO

Does having coronary heart disease affect tobacco dependence, motivation to quit, and quit attempts among adult smokers?

P
Population
Adults aged 35 years and above who provided information on their smoking behavior and CHD status (n = 11,069; 994 [9%] with CHD) from two representative cross-sectional surveys in Germany (DEBRA and OptiCor).
I
Intervention
Presence of coronary heart disease (CHD)
C
Comparator
Absence of coronary heart disease (without CHD)
O
Outcome
Smoking status, tobacco dependence, motivation to quit smoking, attempts to quit, and use of electronic inhalation products (e-cigarettes, tobacco heaters)patient reported

Main Result

Absolute Event Rate: 23.8% vs 29.3%

Although smokers with CHD have higher tobacco dependence, they also demonstrate greater motivation and more frequent attempts to quit compared to smokers without CHD, emphasizing the need for targeted cessation interventions.

Cite This Study

Klosterhalfen et al. (2026) conducted a cross-sectional in Coronary heart disease (n=11,069). Coronary heart disease vs. Without coronary heart disease was evaluated on Current smoking status. Adults with coronary heart disease were less likely to be current smokers (23.8% vs 29.3%) but showed higher motivation to quit (OR 1.41) and more quit attempts (OR 2.90) than those without CHD.

synapsesocial.com/papers/69fecfcdb9154b0b82876cdbhttps://doi.org/10.3238/arztebl.m2026.0057

Topics

Coronary artery disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey2020 · 20 citations
  2. 2Effect of type D personality on smoking status and their combined impact on outcome after acute myocardial infarction2018 · 26 citations
  3. 3Barriers and facilitators for smoking cessation in chronic smokers with atherosclerotic cardiovascular disease enrolled in a randomized intervention trial: A qualitative study2023 · 19 citations
  4. 4Impact of smoking cessation on cardiovascular outcomes in patients with myocardial infarction with nonobstructive coronary arteries2025 · 4 citations
  5. 5Impact of tobacco smoking and smoking cessation on cardiovascular risk and disease2008 · 174 citations