An intensive smoking cessation intervention reduced hospital admissions and mortality in high risk smokers with CVD

doi:10.1136/ebm.12.4.113

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Evidence-Based Medicine 2007;12:113; doi:10.1136/ebm.12.4.113
Copyright © 2007 by the BMJ Publishing Group Ltd.

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Therapeutics

An intensive smoking cessation intervention reduced hospital admissions and mortality in high risk smokers with CVD

Mohiuddin SM, Mooss AN, Hunter CB, et al. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest 2007;131:446–52.[CrossRef][Medline]

Q In high risk smokers hospitalized for cardiovascular disease, does an intensive behavioural plus pharmacotherapy smoking cessation intervention plus usual care after discharge reduce hospital admissions and mortality more than usual care alone?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Internal medicine $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Cardiology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Respirology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$

Key Words: behaviour therapy • bupropion • cardiovascular diseases • directive counselling • dopamine uptake inhibitors • smoking cessation

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: {not concealed^*}.

Blinding: unblinded.^*

Follow up period: 2 years.

Setting: coronary care unit in a university hospital in Nebraska, USA.

Patients: 209 patients 30–75 years of age (mean age 55 y, 63% men)who were admitted to the coronary care unit with acute coronarysyndrome or decompensated heart failure, had smoked for $>=$ 5 years,and had a Fagerstrom score >7. Exclusion criteria includedcurrent alcohol or illicit substance addiction.

Intervention: an intensive smoking cessation intervention plus usual care(n = 109) or usual care only (n = 100). The intensive interventionincluded weekly 60 minute counselling sessions for $>=$ 3 monthsafter discharge and individualised nicotine replacement therapyand/or bupropion at no cost. Intervention group patients werere-treated if they started smoking again. Usual care includedwritten self help materials and a 30 minute counselling sessionbefore discharge.

Outcomes: point prevalence (no smoking since . . . [Full text of this article]

Charles J Bentz, MD, FACP

Providence, St Vincent Hospital and Medical Center, Portland, Oregon,
USA