Randomised controlled trial of smoking cessation intervention after admission for coronary heart disease

A smoking cessation programme delivered by cardiac nurses without special training, significantly reduced smoking rates in patients 12 months after admission to hospital for coronary heart disease.

Abstract

OBJECTIVE: To determine whether a nurse led smoking cessation intervention affects smoking cessation rates in patients admitted for coronary heart disease. DESIGN: Randomised controlled trial. SETTING: Cardiac ward of a general hospital, Norway. PARTICIPANTS: 240 smokers aged under 76 years admitted for myocardial infarction, unstable angina, or cardiac bypass surgery. 118 were randomly assigned to the intervention and 122 to usual care (control group). INTERVENTION: The intervention was based on a booklet and focused on fear arousal and prevention of relapses. The intervention was delivered by cardiac nurses without special training. The intervention was initiated in hospital, and the participants were contacted regularly for at least five months. MAIN OUTCOME MEASURE: Smoking cessation rates at 12 months determined by self report and biochemical verification. RESULTS: 12 months after admission to hospital, 57% (n = 57/100) of patients in the intervention group and 37% (n = 44/118) in the control group had quit smoking (absolute risk reduction 20%, 95% confidence interval 6% to 33%). The number needed to treat to get one additional person who would quit was 5 (95% confidence interval, 3 to 16). Assuming all dropouts relapsed at 12 months, the smoking cessation rates were 50% in the intervention group and 37% in the control group (absolute risk reduction 13%, 0% to 26%). CONCLUSION: A smoking cessation programme delivered by cardiac nurses without special training, significantly reduced smoking rates in patients 12 months after admission to hospital for coronary heart disease.