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Factors associated with persistent smoking after the diagnosis of cardiovascular disease
Hyo-Eun Kim1, Yun-Mi Song, Bo-Kyoung Kim
1Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Many cardiovascular disease (CVD) survivors continue smoking after diagnosis. Factors like regular drinking and family smoking habits increase this risk, while lower education and diabetes may reduce it.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Cigarette smoking is a primary modifiable risk factor for cardiovascular disease (CVD).
- A significant number of CVD survivors struggle to quit smoking post-diagnosis.
- Factors influencing smoking cessation after CVD events remain underexplored.
Purpose of the Study:
- To identify factors associated with continued smoking behavior after a cardiovascular disease (CVD) diagnosis.
- To analyze the relationship between socioeconomic, behavioral, and clinical characteristics and smoking cessation in CVD patients.
Main Methods:
- Utilized data from 16,807 participants in the fourth Korean National Health and Nutrition Examination Surveys.
- Selected 180 participants with a prior CVD diagnosis (angina, myocardial infarction, stroke) who were active smokers at diagnosis.
- Employed logistic regression to assess multivariable-adjusted associations with smoking cessation post-CVD.
Main Results:
- Over 63% of CVD patients continued smoking after diagnosis.
- Regular drinking (OR=4.44) and having smoking family members (OR=5.86) significantly increased the risk of persistent smoking.
- Lower education (OR=0.20), heavier smoking (OR=0.95), longer time since diagnosis (OR=0.88), and diabetes (OR=0.36) were associated with decreased risk of continued smoking.
Conclusions:
- A substantial proportion of Korean CVD patients persist in smoking.
- Tailored interventions considering patient characteristics are crucial for effective smoking cessation.
- More aggressive smoking cessation strategies are needed for CVD survivors to reduce public health burden.
Background:
Although cigarette smoking is a major modifiable risk factor for the occurrence of primary and secondary cardiovascular disease (CVD), not all survivors from CVD attacks can successfully stop smoking. However, little is known about the factors associated with the change in smoking behavior after CVD attack.
Methods:
Study subjects included 16,807 participants (≥19 years) in the fourth Korean National Health and Nutrition Examination Surveys. From them, we selected 180 persons who had previous CVD diagnosis (angina pectoris, myocardial infarction, or stroke) and were smoking at the time of CVD diagnosis. Then, we categorized the 180 persons into two groups according to change in smoking status after the CVD: quitter and non-quitter. Logistic regression analysis was done to evaluate multivariable-adjusted association.
Results:
Even after CVD diagnosis, 63.60% continued to smoke. Fully-adjusted analysis revealed that regular drinking (odds ratio [OR], 4.44) and presence of smokers among family members (OR, 5.86) were significantly (P < 0.05) associated with greater risk of persistent smoking, whereas lower education level (OR, 0.20), larger amount of smoking (OR, 0.95), longer time since diagnosis (OR, 0.88), and diabetes (OR, 0.36) were significantly (P < 0.05) associated with decreased risk of persistent smoking after CVD.
Conclusion:
A great proportion of CVD patients tended to continue smoking in the Korean population. In order to reduce smoking rates among CVD patients further, more aggressive efforts towards smoking cessation should be continuously made with consideration of individual socioeconomic, behavioral, and clinical characteristics of CVD patients.
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