Social Smoking Environment and Associations With Cardiac Rehabilitation Attendance

Area of Science:

• Cardiology
• Public Health
• Behavioral Science

Background:

• Continued smoking post-cardiac event worsens outcomes and reduces cardiac rehabilitation (CR) participation.
• Identifying factors associated with CR attendance and smoking cessation is crucial for high-risk cardiac patients.

Purpose of the Study:

• To investigate the association between smoking among social connections and CR participation in cardiac patients.
• To determine if social smoking influences continued smoking in patients post-cardiac event.

Main Methods:

• 149 post-acute cardiac event smokers eligible for CR completed surveys on smoking habits.
• Participants were grouped based on the proportion of currently smoking friends/family ('None-Few' vs 'Some-Most').
• Outcomes included CR attendance and smoking cessation at 3-month follow-up, analyzed using t-tests, chi-squared tests, and odds ratios (ORs).

Main Results:

• Patients with more smoking social connections ('Some-Most' group) had higher secondhand smoke exposure (P < .01).
• The 'Some-Most' group was significantly less likely to attend CR (OR = 0.40; 95% CI, 0.17-0.93).
• A trend towards lower smoking cessation in the 'Some-Most' group was observed but not statistically significant.

Conclusions:

• A social environment with more smokers is associated with poorer outpatient CR attendance.
• Clinicians should assess patients' social networks for smoking as a potential barrier to behavior change.
• Understanding social influences is key to improving care and outcomes for cardiac patients who smoke.