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Smoking cessation in relation to cardiac procedures
1Department of Medicine, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, NC.
Insights
Coronary artery bypass graft surgery patients were more likely to quit smoking than those undergoing angioplasty or angiography alone. This highlights the importance of monitoring behavior change in cardiac procedure trials.
Area of Science:
- Cardiology
- Behavioral Science
- Public Health
Background:
- Smoking is a major risk factor for coronary heart disease.
- Cardiac procedures offer opportunities to assess smoking cessation behaviors.
- Understanding cessation rates post-procedure is crucial for patient management.
Purpose of the Study:
- To compare smoking cessation rates after coronary artery bypass graft surgery versus percutaneous transluminal coronary angioplasty or angiography alone.
- To evaluate the impact of different cardiac procedures on long-term smoking behavior.
- To provide rationale for monitoring behavioral changes in clinical trials.
Main Methods:
- Prospective study involving 135 patients who were smokers at baseline.
- Data collected between 1985-1988 at Bowman Gray School of Medicine.
- Follow-up smoking history obtained one year or more post-procedure (surgery, angioplasty, or angiography).
Main Results:
- One year post-procedure, 55% of surgery patients were nonsmokers compared to 25% for angioplasty and 14% for angiography (p<0.025 for surgery vs. angioplasty; p<0.001 for surgery vs. angiography).
- These significant differences in smoking cessation persisted after controlling for the number of vessels with significant stenosis.
- Coronary artery bypass graft surgery was associated with substantially higher smoking cessation rates.
Conclusions:
- Coronary artery bypass graft surgery is associated with significantly higher smoking cessation rates compared to less invasive cardiac procedures.
- The findings underscore the importance of assessing and supporting smoking cessation in patients undergoing cardiac interventions.
- Continued monitoring of behavior change is recommended in comparative clinical trials involving surgical and non-surgical cardiac treatments.
Abstract:
In order to compare smoking cessation associated with coronary artery bypass graft surgery (surgery) with that associated with other cardiac procedures (percutaneous transluminal coronary angioplasty (angioplasty) or angiography alone), the authors contacted, in 1985-1988, 135 patients (smokers at baseline) at Bowman Gray School of Medicine, Winston-Salem, North Carolina, one year or more following one or the other of these procedures and obtained a follow-up smoking history. One year after the procedure, 55% of surgery patients, 25% of angioplasty patients, and 14% of angiography patients reported that they were nonsmokers (p less than 0.025 and p less than 0.001 for surgery vs. angioplasty or angiography, respectively). These results persisted after control for the number of vessels with stenosis of greater than or equal to 50%. These data provide rationale for continued monitoring of behavior change throughout the course of clinical trials in which surgical and non-surgical interventions are compared with one another, and support the importance of evaluating effects of exposure to various cardiac procedures in studies of smoking behavior in coronary heart disease patients.