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Success of smoking cessation is associated with immediacy of quitting after an acute coronary syndrome

Session Poster Session III - Friday 08:30 - 12:30

Speaker Marjolein Snaterse-Zuidam

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Tobacco
  • Session type : Poster Session

Authors : M Snaterse-Zuidam (Amsterdam,NL), WJM Scholte Op Reimer (Amsterdam,NL), M Minneboo (Amsterdam,NL), HT Jorstad (Amsterdam,NL), SM Boekholdt (Amsterdam,NL), G Terriet (Amsterdam,NL), RJG Peters (Amsterdam,NL)

M Snaterse-Zuidam1 , WJM Scholte Op Reimer2 , M Minneboo3 , HT Jorstad3 , SM Boekholdt3 , G Terriet4 , RJG Peters3 , 1Amsterdam University of Applied Sciences, School of Nursing - Amsterdam - Netherlands , 2Amsterdam University of Applied Sciences, School of Nursing/Academic Medical Center - Amsterdam - Netherlands , 3Academic Medical Center, University of Amsterdam, Department of Cardiology - Amsterdam - Netherlands , 4Academic Medical Center of Amsterdam, General Practice - Amsterdam - Netherlands ,


Guidelines stress the importance of smoking cessation and recommend intensive follow-up. Successful nonpharmacological strategies for smoking cessation in cardiovascular disease (CVD) patients are, however, still scarce. 

We used data from the Randomised Evaluation of Secondary Prevention for ACS patients coordinated by Outpatient Nurse SpEcialists (RESPONSE) trial (n=754). The study was designed to quantify the impact of a hospital-based nurse-coordinated prevention programme. For the current analysis we included all smokers (324/754 (43%)). 

The majority of successful quitters succeeded to quit immediately after the event and remained quitted up to one year of follow-up, without extra help (128/156 (82%)). Having higher education (33% vs. 15%, p<0.01) and no history of CVD (87% vs. 74%, p<0.01), were associated with successful quitting. 

The majority of successful quitters had stopped immediately after their ACS. It was in their own ability to quit and they remain quitted up to one-year follow-up. There is no evidence to support relapse prevention in ACS patients who stop smoking immediately after the event, and our study indicates that there is no need for it.

Successful quitters n=156 Smokers n=168 P-value
Male, n (%) 127 (81%) 125 (74%) 0.13
College or university 49 (33%) 25 (15%) p<0.01
No history of CVD, n (%) 136 (87%) 124 (74%) p<0.01
Risk profile at baseline
SBP >140 mmHg 36 (24%) 33 (20%) 0.12
LDL >2.5 mmol/L 46 (31%) 66 (39%) 0.15
BMI >25 kg/m2 116 (74%) 115 (68%) 0.12
Inadequate physical activity† 89 (57%) 98 (58%) 0.81
Risk profile at one-year follow-up
SBP >140 mmHg 41 (28%) 43 (26%) 0.79
LDL >2.5 mmol/L 32 (22%) 62 (37%) p<0.01
BMI >25 kg/m2 127 (81%) 112 (67%) p<0.01
1 Defined as non-smoking at outcome assessment date; 2 Between successful quitters and smokers; 3 Note that these 30 relapsers are a subgroup of the 168; SBP systolic blood pressure; LDL low density cholesterol; BMI body mass index; † <30 min./5 times a week

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