Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease

Syed M. Mohiuddin, Aryan N. Mooss, Claire B. Hunter, Timothy L. Grollmes, David A. Cloutier, Daniel E. Hilleman

Research output: Contribution to journalArticle

189 Citations (Scopus)

Abstract

Purpose: To compare an intensive smoking cessation intervention against usual care in hospitalized high-risk smokers with acute cardiovascular disease. Methods: A total of 209 hospitalized smokers were randomized to the intensive intervention (n = 109) or to usual care (n = 100). Usual care consisted only of counseling and printed educational material provided prior to hospital discharge. Intensive treatment consisted of a minimum of 12 weeks of behavior modification counseling and individualized pharmacotherapy provided at no cost to the participant. Smoking status in all subjects was confirmed biochemically (ie, by measuring expired carbon monoxide) at 3, 6, 12, and 24 months after randomization. Outcomes included point prevalence and continuous abstinence smoking cessation rates, hospitalizations, and all-cause mortality. Results: At each follow-up interval, point prevalence and continuous abstinence smoking cessation rates were significantly greater in the intensive-treatment group compared to the usual-care group. At 24 months, continuous abstinence smoking cessation rates were 33% in the intensive-treatment group and 9% in the usual-care group (p <0.0001). Over the 2-year follow-up period, 41 patients in the usual-care group were hospitalized compared to 25 patients in the intensive-treatment group (relative risk reduction [RRR], 44%; 95% confidence interval [CI], 16 to 63%; p = 0.007). The all-cause mortality rate was 2.8% in the intensive-treatment group and 12.0% in the usual-care group (RRR, 77%; 95% CI, 27 to 93%; p = 0.014). The absolute risk reduction in mortality was 9.2% with a number needed to treat of 11. Conclusion: Hospitalized smokers, especially those with cardiovascular disease, should undergo treatment with a structured intensive cessation intervention. The duration of the initial treatment should be 3 months.

Original languageEnglish
Pages (from-to)446-452
Number of pages7
JournalChest
Volume131
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Smoking Cessation
Cardiovascular Diseases
Mortality
Numbers Needed To Treat
Risk Reduction Behavior
Therapeutics
Counseling
Confidence Intervals
Behavior Therapy
Acute Disease
Carbon Monoxide
Random Allocation
Hospitalization
Smoking
Costs and Cost Analysis
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. / Mohiuddin, Syed M.; Mooss, Aryan N.; Hunter, Claire B.; Grollmes, Timothy L.; Cloutier, David A.; Hilleman, Daniel E.

In: Chest, Vol. 131, No. 2, 02.2007, p. 446-452.

Research output: Contribution to journalArticle

@article{823cdb2174894dcbac2d662cc9eb91d9,
title = "Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease",
abstract = "Purpose: To compare an intensive smoking cessation intervention against usual care in hospitalized high-risk smokers with acute cardiovascular disease. Methods: A total of 209 hospitalized smokers were randomized to the intensive intervention (n = 109) or to usual care (n = 100). Usual care consisted only of counseling and printed educational material provided prior to hospital discharge. Intensive treatment consisted of a minimum of 12 weeks of behavior modification counseling and individualized pharmacotherapy provided at no cost to the participant. Smoking status in all subjects was confirmed biochemically (ie, by measuring expired carbon monoxide) at 3, 6, 12, and 24 months after randomization. Outcomes included point prevalence and continuous abstinence smoking cessation rates, hospitalizations, and all-cause mortality. Results: At each follow-up interval, point prevalence and continuous abstinence smoking cessation rates were significantly greater in the intensive-treatment group compared to the usual-care group. At 24 months, continuous abstinence smoking cessation rates were 33{\%} in the intensive-treatment group and 9{\%} in the usual-care group (p <0.0001). Over the 2-year follow-up period, 41 patients in the usual-care group were hospitalized compared to 25 patients in the intensive-treatment group (relative risk reduction [RRR], 44{\%}; 95{\%} confidence interval [CI], 16 to 63{\%}; p = 0.007). The all-cause mortality rate was 2.8{\%} in the intensive-treatment group and 12.0{\%} in the usual-care group (RRR, 77{\%}; 95{\%} CI, 27 to 93{\%}; p = 0.014). The absolute risk reduction in mortality was 9.2{\%} with a number needed to treat of 11. Conclusion: Hospitalized smokers, especially those with cardiovascular disease, should undergo treatment with a structured intensive cessation intervention. The duration of the initial treatment should be 3 months.",
author = "Mohiuddin, {Syed M.} and Mooss, {Aryan N.} and Hunter, {Claire B.} and Grollmes, {Timothy L.} and Cloutier, {David A.} and Hilleman, {Daniel E.}",
year = "2007",
month = "2",
doi = "10.1378/chest.06-1587",
language = "English",
volume = "131",
pages = "446--452",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "2",

}

TY - JOUR

T1 - Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease

AU - Mohiuddin, Syed M.

AU - Mooss, Aryan N.

AU - Hunter, Claire B.

AU - Grollmes, Timothy L.

AU - Cloutier, David A.

AU - Hilleman, Daniel E.

PY - 2007/2

Y1 - 2007/2

N2 - Purpose: To compare an intensive smoking cessation intervention against usual care in hospitalized high-risk smokers with acute cardiovascular disease. Methods: A total of 209 hospitalized smokers were randomized to the intensive intervention (n = 109) or to usual care (n = 100). Usual care consisted only of counseling and printed educational material provided prior to hospital discharge. Intensive treatment consisted of a minimum of 12 weeks of behavior modification counseling and individualized pharmacotherapy provided at no cost to the participant. Smoking status in all subjects was confirmed biochemically (ie, by measuring expired carbon monoxide) at 3, 6, 12, and 24 months after randomization. Outcomes included point prevalence and continuous abstinence smoking cessation rates, hospitalizations, and all-cause mortality. Results: At each follow-up interval, point prevalence and continuous abstinence smoking cessation rates were significantly greater in the intensive-treatment group compared to the usual-care group. At 24 months, continuous abstinence smoking cessation rates were 33% in the intensive-treatment group and 9% in the usual-care group (p <0.0001). Over the 2-year follow-up period, 41 patients in the usual-care group were hospitalized compared to 25 patients in the intensive-treatment group (relative risk reduction [RRR], 44%; 95% confidence interval [CI], 16 to 63%; p = 0.007). The all-cause mortality rate was 2.8% in the intensive-treatment group and 12.0% in the usual-care group (RRR, 77%; 95% CI, 27 to 93%; p = 0.014). The absolute risk reduction in mortality was 9.2% with a number needed to treat of 11. Conclusion: Hospitalized smokers, especially those with cardiovascular disease, should undergo treatment with a structured intensive cessation intervention. The duration of the initial treatment should be 3 months.

AB - Purpose: To compare an intensive smoking cessation intervention against usual care in hospitalized high-risk smokers with acute cardiovascular disease. Methods: A total of 209 hospitalized smokers were randomized to the intensive intervention (n = 109) or to usual care (n = 100). Usual care consisted only of counseling and printed educational material provided prior to hospital discharge. Intensive treatment consisted of a minimum of 12 weeks of behavior modification counseling and individualized pharmacotherapy provided at no cost to the participant. Smoking status in all subjects was confirmed biochemically (ie, by measuring expired carbon monoxide) at 3, 6, 12, and 24 months after randomization. Outcomes included point prevalence and continuous abstinence smoking cessation rates, hospitalizations, and all-cause mortality. Results: At each follow-up interval, point prevalence and continuous abstinence smoking cessation rates were significantly greater in the intensive-treatment group compared to the usual-care group. At 24 months, continuous abstinence smoking cessation rates were 33% in the intensive-treatment group and 9% in the usual-care group (p <0.0001). Over the 2-year follow-up period, 41 patients in the usual-care group were hospitalized compared to 25 patients in the intensive-treatment group (relative risk reduction [RRR], 44%; 95% confidence interval [CI], 16 to 63%; p = 0.007). The all-cause mortality rate was 2.8% in the intensive-treatment group and 12.0% in the usual-care group (RRR, 77%; 95% CI, 27 to 93%; p = 0.014). The absolute risk reduction in mortality was 9.2% with a number needed to treat of 11. Conclusion: Hospitalized smokers, especially those with cardiovascular disease, should undergo treatment with a structured intensive cessation intervention. The duration of the initial treatment should be 3 months.

UR - http://www.scopus.com/inward/record.url?scp=33847157996&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33847157996&partnerID=8YFLogxK

U2 - 10.1378/chest.06-1587

DO - 10.1378/chest.06-1587

M3 - Article

C2 - 17296646

AN - SCOPUS:33847157996

VL - 131

SP - 446

EP - 452

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -