Is There any Gender Difference for Smoking Persistence or Relapse Following Diagnosis or Hospitalization for Coronary
Muhammad Aziz Rahman1, Karen-Leigh Edward2, Laura Montgomery3
1Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Australia; Cardiovascular Research Centre (CvRC), Australian Catholic University, Melbourne, Australia; aziz.rahman@y7mail.com drazizdmc@gmail.com.
Insights
Persistent smoking after coronary heart disease (CHD) diagnosis is high in both male and female smokers. There is no gender difference in relapse rates, indicating similar smoking cessation efforts are needed for all patients with CHD.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Persistent smoking significantly increases morbidity and mortality in patients with coronary heart disease (CHD).
- Existing research on gender differences in smoking cessation post-CHD diagnosis lacks conclusive evidence.
- Understanding gender-specific smoking behaviors is crucial for effective public health interventions.
Purpose of the Study:
- To investigate if female smokers with CHD are more likely to persist in smoking or relapse after diagnosis compared to male smokers.
- To analyze gender-based disparities in smoking cessation and relapse rates following CHD events.
- To inform targeted smoking cessation strategies for diverse patient populations.
Main Methods:
- A systematic literature search was conducted on PubMed and Web of Science for studies published within the last 10 years.
- Meta-analyses were performed using a random effects model to synthesize data from eligible studies.
- Included studies comprised a total of 36,591 patients, with 20,617 identified as smokers.
Main Results:
- Females constituted 12% (2,564) of the smoker population in the analyzed studies.
- Meta-analyses of eight studies indicated females were less likely to be smokers at baseline (OR = 0.30, 95% CI = 0.13 to 0.70).
- Approximately 47% of smokers persisted in smoking or relapsed post-CHD diagnosis, with no significant gender difference observed (OR = 1.07, 95% CI = 0.95 to 1.21).
Conclusions:
- Female smokers are less prevalent at baseline among CHD patients, but relapse rates are equally high for both genders.
- The high rate of persistent smoking/relapse underscores the need for robust, gender-neutral smoking cessation programs.
- Sustained cessation efforts are essential for both male and female smokers diagnosed with CHD to improve long-term outcomes.
Introduction:
Persistent smoking in patients diagnosed with coronary heart disease (CHD) has a significant effect on morbidity and mortality. Although there has been considerable debate around gender differences in smoking cessation, conclusive evidence on how gender impacts rates of smoking cessation and/or relapse following CHD diagnosis is lacking.
Aims And Methods:
Our aim was to test the hypothesis that female smokers with CHD were more likely to persist in smoking or relapse post-diagnosis or hospitalization than male smokers. We searched PubMed and Web of Science databases for studies published in the last 10 years. Meta-analyses were conducted using a random effects model.
Results:
Sixteen studies met the inclusion criteria. The aggregated sample size was 36 591, 20 617 (56%) were smokers of which 2564 (12%) were female. Meta-analyses of eight studies where smoking prevalence could be measured, showed that females were less likely to be smokers at baseline than males (OR = 0.30, 95% CI = 0.13 to 0.70). Overall, one in two (47%) smokers persisted in smoking/relapsed following a diagnosis or hospitalization for CHD; but there was no gender difference in the rate of persistent smoking/relapse (OR = 1.07, 95% CI = 0.95 to 1.21).
Conclusions:
Female smokers with CHD were relatively uncommon in the included study populations. However, the rate of persistent smoking/relapse was high in both female and male smokers following a diagnosis or hospitalization for CHD. Therefore similar, sustained smoking cessation efforts are warranted for both genders.
Implications:
There was no gender difference for persistent smoking/relapse following a diagnosis or hospitalization for CHD, but the rate was high in both female and male smokers. Therefore, similar, sustained smoking cessation efforts are warranted for both genders.
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