Key result
Higher self-efficacy linked to ~7% higher post-MI smoking cessation odds.
Why the study?
Although smoking cessation reduces MI recurrence, morbidity, and mortality, only half of patients quit or reduce smoking after hospitalization, prompting examination of cessation practices and associated factors at 6-12 months post-MI.
Cross-Sectional (n=230)
No
Although nearly all hospitalized myocardial infarction patients in this Armenian cohort attempted to quit smoking, only half maintained abstinence at 6 to 12 months, highlighting a critical gap in formal smoking cessation assistance (Assist and Arrange components) and pharmacotherapy utilization.
Answers are grounded in this paper and cite their sources.
Self-efficacy may aid post-MI cessation; leaves open whether targeted interventions improve rates in prospective trials.
INTRODUCTION: The effectiveness of smoking cessation in preventing myocardial infarction (MI) and reducing its recurrence, morbidity and mortality is well established. Only half of the patients quit or reduce smoking after hospitalization. The study examined smoking cessation practices and factors associated with it at 6-12 months after hospitalization among smoker patients diagnosed with MI. METHODS: A cross-sectional survey (2016-2017) was conducted among smoker adult patients who were diagnosed with MI and were hospitalized at the largest cardiac hospital (Nork-Marash Medical Center) in Armenia. Data collection was conducted via medical record review and an interviewer-administered telephone survey (n=230). The patients were classified as non-quitters or quitters (those had not smoked even a puff within the past 30 days). Multivariate logistic regression analysis was used to examine factors associated with smoking cessation at 6-12 months post-hospitalization addressing multicollinearity with two separate regression models. RESULTS: The mean age of participants was 58.3 years and 98.3% were males. Though almost all MI patients attempted to quit, only 52.2% were successful abstainers at 6-12 months after hospitalization. Significant predictors of quitting included higher self-efficacy (AOR=1.07; 95% CI: 1.03-1.11, p<0.001), lower tobacco dependence (AOR=0.81; 95% CI: 0.66-1.00, p=0.050), not having family members who smoked (Model 1: AOR=0.24; 95% CI: 0.08-0.70, p=0.009; and Model 2: AOR=0.24; 95% CI: 0.09-0.67, p=0.006), having other hospitalization after MI due to heart disease (Model 1: AOR=5.42; 95% CI: 1.50-19.65, p=0.010; and Model 2: AOR=4.20; 95% CI: 1.32-13.31, p=0.015), higher number of household members (Model 1: AOR=1.83; 95% CI: 1.27-2.64, p=0.001; and Model 2: AOR=1.68; 95% CI: 1.20-2.35, p=0.002), and having at least one comorbidity (Model 1: AOR=4.20; 95% CI: 1.47-12.04, p=0.008; and Model 2: AOR=3.74; 95% CI: 1.40-9.97; p=0.008). CONCLUSIONS: The study emphasized the need for integrating evidence-based cessation services and targeted help for hospitalized MI patients in Armenia. Interventions should aim to improve self-efficacy, effectively treat dependence, and consider patients' social environment while providing cessation assistance.
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Hayrumyan et al. (2023) conducted a cross-sectional in Myocardial Infarction in Smokers (n=230). Self-efficacy score (and other psychosocial/clinical predictors of quitting) vs. Lower self-efficacy / non-quitters was evaluated on Smoking cessation (30-day abstinence) at 6-12 months post-hospitalization associated with self-efficacy score (AOR 1.07, 95% CI 1.03-1.11, p=<0.001). Among smokers hospitalized for MI, 52.2% quit at 6-12 months, with higher self-efficacy predicting cessation.
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