Healthcare providers have long known smoking to be a risk factor in the development of heart disease. We studied the perceptions of smokers with and without self-reported cardiac co-morbidities enrolled in our tobacco dependence program.
Six weekly sessions emphasized behavior modification and pharmacological interventions. Innovative therapies of humor, grief counseling, and guided imagery were utilized. Data collected from cessation program questionnaires from 2000-2003 focusing on smoking and medical history were analyzed using SAS®. Quit status was bio-chemically verified with exhaled carbon monoxide levels.
1023 patients total; 375 reported a history of cardiac co-morbid conditions (43% males vs. 32% females p<0.0006) such as hypertension, angina, MI, arrhythmia. Mean age for patients reporting cardiac co-morbidities was higher (53.4 vs. 44.4 p<0.0001) as were the pack-years (39.4 vs. 31.9 p<0.0001). The Cardiac group was 2x as likely to have been hospitalized in the past year (p<0.02) and much more likely to report ’Depression’ as an additional co-morbidity (p<0.0001). Only a minority of the Cardiac group were more likely to cite ‘a recent change in health status’ (29.0% vs. 10.6%, p<0.0001), or ‘pressure from physician’ (26.1% vs. 15.7%, p<0.0001) as a reason for quitting. The quit success of both groups was similar (55.9% vs. 55.1%) at one month.
Older smokers with greater pack-years, who were more frequently hospitalized, reported cardiac co-morbidities more often. With only a small minority of the cardiac group citing ’health reasons’/’physician input’ as factors in the impetus for their quit attempt, this indicates a need to put more emphasis on patient education. While advising smokers to quit, healthcare providers need to more thoroughly explain the connection between smoking and their heart disease. This issue, when properly addressed, can be useful as an additional tool to aid patients in quitting.
Early intervention with effective treatment for tobacco dependence can reduce the prevalence of heart disease. Ultimately, this may also decrease the economic burden of treating cardiac illnesses.
V.C. Reichert, None.