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Smoking Cessation Intervention in a Cardiovascular Hospital Based Clinical Setting

DOI: 10.1155/2012/970108

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Abstract:

Introduction. Smoking is a leading cause of morbidity and mortality globally and it is a significant modifiable risk factor for cardiovascular disease (CVD) and other chronic diseases. Efforts to encourage and support smokers to quit are critical to prevent premature smoking-associated morbidity and mortality. Hospital settings are seldom equipped to help patients to quit smoking thus missing out a valuable opportunity to support patients at risk of smoking complications. We report the impact of a smoking cessation clinic we have established in a tertiary care hospital setting to serve patients with CVD. Methods. Patients received behavioural and pharmacological treatments and were followed up for a minimum of 6 months (mean 541 days, SD 197 days). The main study outcome is ≥50% reduction in number of cigarettes smoked at followup. Results. One hundred and eighty-six patients completed ≥6 months followup. More than half of the patients (52.7%) achieved ≥50% smoking reduction at follow up. Establishment of a plan to quit smoking and use of nicotine replacement therapy (NRT) were significantly associated with smoking reduction at followup. Conclusions. A hospital-based smoking cessation clinic is a beneficial intervention to bring about smoking reduction in approximately half of the patients. 1. Introduction Smoking is a leading cause of premature and preventable death worldwide claiming the lives of over 5 million people each year [1]. Twenty percent of Canadians over the age of 15 years continue to smoke [2]. Lifelong smokers die 10 years earlier than nonsmokers [3]. However, these lost life years can be regained if smoking cessation occurs early [3, 4]. Smoking therefore represents one of the most important modifiable risk factors which when changed can prevent significant mortality and morbidity. Nicotine (a component of cigarettes) is an addictive substance [5] similar in its addictive properties to other addictive substances including opioids and alcohol where nicotine-dependence is manifested by physical withdrawal symptoms and the continued use of smoking to relieve such symptoms [6]. Therefore, attempts to quit smoking can be challenging needing specialized treatments and interventions. Both population and individual tobacco prevention and treatment strategies are required to minimize tobacco use and to reduce the exposure of nonsmokers to secondhand smoke. Effective strategies include increased taxation on tobacco products [7] and banning smoking in public places. In hospital settings, smokers commonly present with life-threatening conditions

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