043: Promoting smoking cessation during hospitalization for coronary artery disease

BackgroundQuitting smoking is the most effective intervention to reduce mortality in patients with coronary artery disease who smoke. Our department has implemented an institutional program to identify and treat all smokers admitted to the department.ObjectivesThe objectives of the present paper are to describe core elements of this program and present data concerning its reach and effectiveness.Program descriptionThe goal of the program is to increase the number of smokers who are abstinent from smoking six months after a coronary artery disease-related hospitalization.ResultsBetween January 2009 and April 2009, almost 109 smokers were identified at admission, and 72.5% received intervention to help them quit smoking. The average age was 52.6+/-8 years in the group “with intervention” and 53.6+/-7 in the group “without intervention” The smoking status of our patients was similar between the two groups: in fact, the average age of onset of active smoking patients was 18.6 years in group “without intervention” and 19.4 years in group “with intervention” (p=0.41). At six-month follow-up, 76.7% of those receiving intervention were smoke-free against 55.7% of the group “without intervention” (p=0.04). In univariate analysis the absence of smoking intervention was predictive of MACCE in the medium term (OR=0.2, 95% CI [0.1 to 0.8]). In multivariate logistic regression analysis, predictors of smoking at six months after a coronary artery disease-related hospitalization were: the absence of receiving intervention at admission, the age of onset of smoking <20 years and the Fagerstrom score at admission> 7.ConclusionsHospitalization for coronary artery disease provides an important opportunity to intervene with smokers when their motivation to quit is high. An institutional approach reinforces the importance of smoking cessation in this patient population and increases the rate of smoking cessation. Post hospitalization quit rates should be a benchmark of cardiac program performance