The Mode Of Smoking Cessation Study In Coronary Heart Disease Patients

Smoking is an important risk factor for coronary heart disease, and quit smoking is the most cost-effective means of secondary prevention for coronary heart disease patients. Overseas studies have shown that smoking cessation intervention on patients from doctors can effectively improve the patient quit rates. However, tobacco control environment is not optimistic in China and the research of smoking cessation in patients with coronary heart disease is rare. In this study, tobacco control start from the medical staff, and aims to explore suitable and successful smoking cessation patterns in China, as well as to optimize the integrated management of chronic disease.PartⅠ:Smoking cessation rate in cardiovascular patients after percutaneous coronary interventionObjective To investigate the smoking cessation rate and related factors in cardiovascular patients after percutaneous coronary intervention.Method A cross-sectional survey of 1241 out-patients or in-patients who met the inclusion criteria was conducted in 14 hospitals over the country.Result The survey population mainly consisted of middle-aged male patients, the average age is 59.9±10.7 years old, the median time after surgery is 1.5 years, 77.4% tried to quit smoking while 55.4% succeed. The older men were more likely to try to quit smoking and quit smoking eventually (OR values were 1.02.1.03 respectively). The higher smoking amount of cigarettes every day, the greater possibility of trying to quit smoking (OR=1.03), but less likely to quit smoking eventually (OR=0.97). Besides, years of smoking and cessation motivation have impacts on the cessation behavior as well.Conclusion The smoking cessation rate of patients after one year PCI is more than half, and ages, years of smoking, smoking amount of cigarettes every day, diseases and advices from doctors are influence factors of smoking cessation.PartⅡ:Smoking cessation intervention in coronary disease patients Objective To evaluate the effects of smoking cessation interventions in coronary disease patients, and to explore suitable and successful smoking cessation patterns in China, as well as to optimize the integrated management of chronic disease.Method 16 major hospitals from the countrywide were selected with the city and hospital level factors matched, and randomly divided into two groups:the intervention group and the control group, each group had 8 hospitals. Smoking coronary heart disease patients, both inpatients and outpatients were recruited at the department of cardiology at the 16 hospitals. Each research center planned to collect 40 patients, and patients were continuously enrolled in until the expected sample size. Patients in the control group were given self-help smoking cessation materials and simple advice to quit smoking from doctors and patients in the intervention group were given self-help smoking cessation materials and individual consultant on smoking cessation by smoking cessation commissioner. After discharge they were followed up through text messages delivered by platform, telephone calls and regular hospital visit. Information collection was conducted by doctors under uniform training and smoking status was confirmed by testing nicotine metabolite in the urine.Result 607 cases were collected, of which 304 cases in the intervention group and 303 cases in the control group. Subjects were mainly middle-aged men,586 men (96.38%); the average age was 56.3±9.8 years. Occupation was mainly constitutive of retired 128 (21.09%), workers 124 (20.43%), and cadres and staff 119 (19.6%). High levels of education were 213 (35.09%), middle level of 179 (29.49%), university level 143 (23.56%) and primary and below 72 (11.86%). Baseline demographic characteristics were almost balance between the two groups. PP set analysis result:up for 3 months continuous abstinence rate was 44.2% in the control group and 55.8% in the intervention group, there were statistically significant differences between the groups (P=0.005), OR was 1.59,95%CI:1.15-2.20; up for 6 months continuous abstinence rate was 44.1% in the control group and 55.6% in the intervention group, there were statistically significant differences between the groups (P=0.008), OR was 1.59,95%CI:1.13-2.23. ITT set analysis result:up for 3 months continuous abstinence rate was 42.90% in control group,53.95% in intervention group, statistically significant difference between the two groups (P=0.016), OR was 1.56, 95% CI:1.13-2.15; follow-up 6 months continuous abstinence rate of the control group was 40.59%,47.7% intervention group, no significant difference between the groups (P=0.008), OR is 1.33,95% CI:0.97-1.84. Factors analysis showed that intervention group and the confidence on quitting smoking are the influencing factors, and the effects of confidence on quitting smoking are greater than intervention group (OR 2.77 vs.1.81).Conclusion Smoking cessation effect of intervention group was better than the control group. The psychosocial interventions in coronary heart disease patients obtains preliminary effect under Chinese tobacco control environment, and provided valuable evidence to optimize the management of chronic diseases.