Smoking cessation after coronary angiography and percutaneous coronary intervention

Smoking is a crucial modifiable risk factor for coronary artery disease. However, effective support in smoking cessation (SC) and data regarding factors related to SC are still inadequate.

We aimed to assess SC rates and factors related to effective SC in patients after coronary angiography (CA).

Patients who underwent CA between 2014 and 2018 at a single center in Poland were screened for active smoking. After at least 6 months after the procedure, the patients were contacted by telephone to obtain information about their current smoking status and history of smoking during the follow‑up.

A total of 3719 consecutive patients were screened. Of these, 921 (24.8%) declared active smoking. At least 6 months after CA, 241 patients were available for a follow‑up interview. The mean (SD) age of the patients was 61.2 (9.3) years, 168 (69.7%) were men, and 115 (47.7%) had acute coronary syndrome. The mean (SD) duration of hospitalization was 6 (4.4) days, and 67 patients (27.8%) were scheduled for a second‑stage procedure. A total of 80 patients (33.2%) declared SC at the 6‑month follow‑up. The multivariable logistic regression analysis indicated that duration of hospitalization equal to or greater than 4 days (odds ratio [OR], 3.62; 95% CI, 1.9-6.89), the Fagerström score equal to or lower than 4 points (OR, 1.96; 95% CI, 1.01-3.79), a scheduled second hospitalization (OR, 2.54; 95% CI, 1.32-4.86), and a smoking load greater than or equal to 51 pack‑years (OR, 2.28; 95% CI, 1.16-4.47) increased the chance of SC.

A substantial number of patients who underwent CA were current smokers, with low SC rates in the follow‑up. A prolonged hospital stay, scheduled second hospitalization, low nicotine dependence but also a high load of pack‑years increased the chances of SC, which underscores the need for intensive and repetitive in‑hospital counseling in the whole population of smokers.