• Muhammad Ammad Abbasi ATH
  • Saqib Malik PINC
  • Khurshid Ali PINC


Background: The long-term cardiovascular health risks associated with cigarette smoking are well established. It is a major risk factor for all manifestations of coronary artery disease, stroke, and peripheral vascular disease. Patients with acute coronary syndrome, who quit smoking, reduce their risk of cardiovascular events immediately and significantly when compared to those who continue smoking. The study was conducted to determine the frequency of smoking cessation after counselling in patients presenting with acute coronary syndrome (ACS). Methods: Patients of age 35-80 years of either gender presenting with Acute coronary syndrome presented in emergency within 12 hours of symptoms having history of smoking (>1pack year for >5 years) were included in the study. A total 225 patients were enrolled in the study from emergency of Punjab institute of cardiology, Lahore for the duration of six months. Informed consent was obtained from all patients. Their demographic information was also noted. Then patients under went counselling session with researcher himself in presence of psychiatrist from Department of Psychiatry, Services hospital, Lahore. After admitting patients in ward, patients received standard in-hospital treatment for smoking cessation which consisted of an assessment of their smoking behaviour and a personalized brief quit advice. Then patients were followed-up for 12 weeks. On weekly visit, patients were counselled for smoking cessation. After 12 weeks, patients were assessed for cessation of smoking. Results: Smoking cessation was seen in only 37 (16.4%) in ACS patients. Highest frequency of smoking cessation was seen in patients >65 years of age, i.e., 35.1%. Highest frequency for smoking cessation was seen in patients whose BMI was <30 (70.3%), patients with low socioeconomic status (45.9%) and patients with educational status as under matric (40.5%). None of these factors were significantly associated with smoking cessation in patients who presented with ACS. Conclusion: Results of this study demonstrate low frequency of smoking cessation among patients presenting with ACS. However, there is a strong need to identify those factors that were associated with failure to reduce smoking.Keywords: Smoking cessation; Counselling; Acute coronary syndrome

Author Biographies

Muhammad Ammad Abbasi, ATH

Department of MedicineATHAbbottabad

Saqib Malik, PINC


Khurshid Ali, PINC



Berndt N, Bolman C, Lechner L, Mudde A, Verheugt FW, de Vries H. Effectiveness of two intensive treatment methods for smoking cessation and relapse prevention in patients with coronary heart disease: study protocol and baseline description. BMC Cardiovasc Disord 2012;12:33.

Shah AM, Pfeffer MA, Hartley LH, Moyé LA, Gersh BJ, Rutherford JD, et al. Risk of all-cause mortality, recurrent myocardial infarction, and heart failure hospitalization associated with smoking status following myocardial infarction with left ventricular dysfunction. Am J Cardiol 2010;106(7):911–6.

Hbejan K. Smoking Effect on Ischemic Heart Disease in Young Patients. Heart Views 2011;12(1):1–6.

Berndt N, Bolman C, Mudde A, Verheugt F, de Vries H, Lechner L. Risk groups and predictors of short-term abstinence from smoking in patients with coronary heart disease. Heart Lung J Acute Crit Care 2012;41(4):332–43.

Costa ML, Cohen JE, Chaiton MO, Ip D, McDonald P, Ferrence R. “Hardcore” definitions and their application to a population-based sample of smokers. Nicotine Tob Res 2010;12(8):860–4.

Colivicchi F, Mocini D, Tubaro M, Aiello A, Clavario P, Santini M. Effect of smoking relapse on outcome after acute coronary syndromes. Am J Cardiol 2011;108(6):804–8.

Moreno Ortigosa A, Ochoa Gómez FJ, Ramalle-Gomara E, Saralegui Reta I, Fernandez Esteban MV, Quintana Díaz M. Efficacy of an intervention in smoking cessation in patients with myocardial infarction. Med Clín (Barc) 2000;114(6):209–10.

Croghan G, Croghan I, Frost M, Sloan J, Novotny P, Nelson M, et al. Smoking cessation interventions and post-operative outcomes in esophageal and lung cancer patients. Society for Research on Nicotine and Tobacco 11th Annual Meeting; 2005.

Bolman C, de VH, van Breukelen G. Evaluation of a nurse-managed minimal-contact smoking cessation intervention for cardiac inpatients. Health Edu Res 2002;17(1):99–116.

Rigotti NA, Arnsten JH, McKool KM, Wood-Reid KM, Pasternak RC, Singer DE. Efficacy of a smoking cessation program for hospital patients. Arch Inter Med 1997;157(22):2653–60.

Chouinard MC, Robichaud-Ekstrand S. The effectiveness of a nursing inpatient smoking cessation program in individuals with cardiovascular disease. Nurs Res 2005;54(4):243–54.

Hennrikus DJ, Lando HA, McCarty MC, Klevan D, Holtan N, Huebsch JA, et al. The TEAM project: the effectiveness of smoking cessation intervention with hospital patients. Prev Med 2005;40(3):249–58.

Nagle AL, Hensley MJ, Schofield MJ, Koschel AJ. A randomised controlled trial to evaluate the efficacy of a nurse‐provided intervention for hospitalised smokers. Aust N Z J Public Health 2005;29(3):285–91.

Jonas MA, Oates JA, Ockene JK, Hennekens CH. Statement on smoking and cardiovascular disease for health care professionals. American Heart Association. Circulation 1992;86(5):1664–9.

Wiggers LC, Smets EM, de Haes JC, Peters RJ, Legemate DA. Smoking cessation interventions in cardiovascular patients. Eur J Vasc Endovasc Surg 2003;26(5):467–75.

Critchley JA, Capewell S. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA 2003;290(1):86–97.

Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, et al. ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non–ST-Elevation Myocardial Infarction) Developed in Collaboration With the American Academy of Family Physicians and American College of Emergency Physicians Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, Society for Cardiovascular Angiography and Interventions, and Society of Hospital Medicine. J Am Coll Cardiol 2008;52(24):2046–99.

Dawood N, Vaccarino V, Reid KJ, Spertus JA, Hamid N, Parashar S. Predictors of smoking cessation after a myocardial infarction: the role of institutional smoking cessation programs in improving success. Arch Intern Med 2008;168(18):1961–7.

Colivicchi F, Mocini D, Uguccioni M, Strano S, Imperoli G, Santini M. Smoking cessation interventions after Acute Coronary Syndromes. Results of a cross-sectional survey in the Lazio Region of Italy. Monaldi Arch Chest Dis 2015;78(2):85–8.

Bolman C, De Vries H, van Breukelen G. A minimal-contact intervention for cardiac inpatients: long-term effects on smoking cessation. Prev Med 2002;35(2):181–92.

Hajek P, Taylor TZ, Mills P. Brief intervention during hospital admission to help patients to give up smoking after myocardial infarction and bypass surgery: randomised controlled trial. BMJ 2002;324(7329):87–9.

Rigotti N, Munafo MR, Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Databese Syst Rev 2007;(3):CD001837.

Siahpush M, McNeill A, Borland R, Fong G. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control 2006;15(Suppl 3):iii71–5.

Businelle MS, Kendzor DE, Reitzel LR, Costello TJ, Cofta-Woerpel L, Li Y, et al. Mechanisms linking socioeconomic status to smoking cessation: a structural equation modeling approach. Health Psychol 2010;29(3):262–73.

Reid JL, Hammond D, Boudreau C, Fong GT, Siahpush M. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the International Tobacco Control Four Country Survey. Nicotine Tob Res 2010;12(Suppl 1):S20–33.

Hiscock R, Judge K, Bauld L. Social inequalities in quitting smoking: what factors mediate the relationship between socioeconomic position and smoking cessation? J Public Health (Oxf) 2010;33(1):39–47.




Most read articles by the same author(s)

1 2 > >>