Readiness for smoking cessation in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey

Eur J Prev Cardiol. 2015 Sep;22(9):1212-9. doi: 10.1177/2047487314564728. Epub 2014 Dec 16.

Abstract

Background: Readiness for smoking cessation is an important predictor of quit attempts and cessation success. We aimed to investigate the prevalence and correlates of readiness for smoking cessation in coronary heart disease (CHD) patients.

Design: The EUROpean Action on Secondary and Primary Prevention by Intervention to Reduce Events III (EUROASPIRE III) survey is a cross-sectional study conducted in 2006-2007 among CHD patients <80 years of age from 22 European regions.

Methods: Patients were interviewed on average 15 months after hospital admission for an acute coronary event or procedure. Readiness for smoking cessation was assessed using the smoking stages of change (SSC) short form questionnaire. Breath carbon monoxide was measured to validate self-reported non-smoking.

Results: Among 2585 patients who were smoking prior to hospital admission, 25.6%, 16.8%, 8.1%, 5.6% and 44.0% were in the precontemplation (no intention to quit), contemplation (thinking of quitting), preparation (planning to quit), action (having quit within six months) and maintenance (having quit more than six months ago) stages, respectively. Significant multivariable correlates of advancement in SSC showed positive associations of older age and attended cardiac rehabilitation and negative associations of severe depressive symptoms, longer smoking duration and environmental tobacco smoke (ETS) exposure.

Conclusions: One-quarter of CHD patients across Europe who were smoking prior to hospitalisation have no intention to quit, and an additional quarter is thinking of quitting or planning to quit. Patients who are younger, do not attend cardiac rehabilitation, have severe depressive symptoms, have been smoking for longer periods of time and are exposed to ETS may need to be specifically targeted in cessation interventions.

Keywords: Stages of change; coronary artery disease; epidemiology; smoking cessation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Breath Tests
  • Carbon Monoxide / analysis
  • Coronary Disease / diagnosis
  • Coronary Disease / epidemiology
  • Coronary Disease / psychology
  • Coronary Disease / rehabilitation*
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intention
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Compliance*
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors
  • Risk Reduction Behavior*
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / psychology
  • Smoking Cessation / psychology*
  • Smoking Prevention*
  • Surveys and Questionnaires
  • Time Factors

Substances

  • Carbon Monoxide