Key result
Illicit drug use history is linked to ~46% lower odds of post-STEMI smoking cessation.
Why the study?
Smoking is a major risk factor for coronary heart disease and cessation is critical for secondary prevention after STEMI, prompting evaluation of the 5-year prevalence and predictors of smoking cessation in an Iranian STEMI cohort.
Cohort (n=241)
Long-term smoking cessation after STEMI remains suboptimal at 36.9% at 5 years, with baseline illicit drug use and follow-up psychological distress identifying patients less likely to quit.
Answers are grounded in this paper and cite their sources.
May identify high-risk STEMI subgroup for persistent smoking; leaves open whether targeted interventions improve cessation rates.
Introduction Smoking is a major risk factor for coronary heart disease, and smoking cessation is critical for secondary prevention after STEMI. This study evaluated the 5-year prevalence and predictors of smoking cessation in an Iranian STEMI cohort. Methods This prospective study was conducted as a subgroup analysis of the SEMI-CI registry. Patients who were active smokers at baseline and survived to the 5-year follow-up were included. Smoking status was reassessed by telephone interviews, with participants categorized as quitters or non-quitters. Baseline sociodemographic characteristics, medical history, and clinical variables were evaluated as potential predictors of cessation. Psychological distress at follow-up was assessed using the PHQ-4 and examined for its association with smoking status. Group comparisons were performed using t-tests, Mann–Whitney U tests, and chi-square tests, and univariate logistic regression identified baseline predictors of cessation. Results Of 867 STEMI patients enrolled, 341 were smokers at baseline. At 5 years, 241 participants were analyzed after excluding 52 deaths and 48 losses to follow-up. Overall, 89 (36.9%) quit smoking and 152 (63.1%) continued. Among baseline factors, only a history of illicit drug use was significantly associated with smoking cessation, with lower odds of quitting (OR 0.54, 95% CI 0.31–0.94). Psychological distress (PHQ-4 ≥6) was more prevalent in non-quitters than quitters (41.1% vs. 28.4%, p < 0.05), though this was not included in the regression model. Conclusion Smoking cessation after STEMI remains suboptimal. History of illicit drug use and psychological distress may influence long-term smoking behavior and should be considered in cessation interventions.
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Roohafza et al. (2026) conducted a cohort in ST-Elevation Myocardial Infarction (STEMI) (n=241). History of illicit drug use vs. No history of illicit drug use was evaluated on 5-year smoking cessation (OR 0.54, 95% CI 0.31-0.94). History of illicit drug use was associated with lower 5-year odds of smoking cessation after STEMI, with 36.9% quitting overall.
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