Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction

• Published in: Internal medicine journal Vol. 31; no. 8; pp. 470 - 475
• Main Authors: Feeney, G. F. X., McPherson, A., Connor, J. P., McAlister, A., Young, R. M., Garrahy, P.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Melbourne, Australia Blackwell Science Pty 01-11-2001; Blackwell Science
• Subjects: acute myocardial infarction; Adult; Australia; Biological and medical sciences; Coronary Care Units; Female; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - prevention & control; Program Evaluation; randomized trial; Secondary Prevention; Smoking - adverse effects; smoking cessation; Smoking Cessation - methods; Tobacco, tobacco smoking; Toxicology; treatment programme; Australia; Human; Evaluation; Prognosis; Infarct; Acute; Tobacco smoking; Cardiovascular disease; Coronary heart disease; Myocardial disease; Cigarette; Shutdown; Myocardium; Therapeutic schedule; Comparative study
• ISSN: 1444-0903; 1445-5994
• DOI: 10.1046/j.1445-5994.2001.00110.x

Background: Tobacco cessation after acute myocardial infarction (AMI) substantially improves outcome but how effective individual programmes are needs to be established. To date, few studies have examined this factor.
Aims: To assess the outcome of two smoking cessation programmes after AMI.
Methods: One hundred and ninety‐eight current smokers admitted to coronary care with an AMI participated in a randomized controlled study comparing two outpatient tobacco interventions, the Stanford Heart Attack Staying Free (SF) programme and a Usual Care (UC) programme.
Results: Log–rank analyses revealed that patients in the SF programme were retained longer (P < 0.001) and had higher cotinine validated abstinence rates (P < 0.001) compared with patients in the UC programme. Twelve months after intervention, 39% of the SF programme compared with 2% of the UC programme demonstrated cotinine validated tobacco cessation, representing a significant reduced relapse rate in the SF programme (χ2, P < 0.001).
Conclusions: The SF smoking cessation programme initiated in hospital can significantly reduce smoking rates at 12 months after myocardial infarction. Although superior to the UC quit programme, Australian outcomes were lower than the American programme originators’ published outcomes. (Intern Med J 2001; 31: 470–475)