Tobacco and alcohol use following first vs. consecutive cardiovascular events: a prospective longitudinal study

Examine tobacco and alcohol use patterns in a cohort of patients at their first (FE) or consecutive (CE) admission to a cardiology ward, and trajectories of use between groups over time.

Tobacco and alcohol use was assessed at baseline and after one year on a prospective cohort of 249 patients admitted for CVD using the Timeline Followback method, and the Alcohol, Smoking and Substance Involvement Screening Test. Trajectories within and between groups were analysed using generalized multilevel mixed-effect models for repeated measures.

Baseline prevalence of FE tobacco use was 29.5% and 15.4% in CE. The mean of weekly cigarettes was 35.8 for FE and 30.2 for CE (n.s.). The study found a significant effect of time on the cessation (p < 0.001) and the reduction (p = 0.018) of tobacco use. FE demonstrated a greater reduction in tobacco use prevalence (p = 0.003) and quantity (p < 0.001) -positive interaction between group and time. Baseline prevalence of alcohol use was 63.8% and 41.9% on FE and CE. Although there was a reduction in the prevalence and quantity of alcohol use in both groups, it remained relatively high. Although the occurrence of a cardiovascular event has a significant impact on the reduction of tobacco use, alcohol use appears more resistant to change post-event.