J Korean Acad Nurs.  2016 Aug;46(4):610-617. 10.4040/jkan.2016.46.4.610.

Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

• Lee MJ
• Park E
• Kim HC
• Lee HS
• Cha MJ
• Kim YD
• Heo JH
• Nam HS

• KMID: 2424557
• DOI: http://doi.org/10.4040/jkan.2016.46.4.610

Abstract

PURPOSE
Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke.
METHODS
Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months.
RESULTS
Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was 58.25 ± 11.23 years and mean initial National Institutes of Health Stroke Scale score was 4.68 ± 5.46. The TI group showed a higher point smoking success rate compared with the CC group (p= .003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group.
CONCLUSION
Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

Keyword

Smoking cessation; Cerebral infarction; Behavior control; Sex

MeSH Terms

Adult
Aged
*Counseling
Female
Hospitalization
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Retrospective Studies
Sex Factors
Smoking Cessation/*statistics & numerical data
Stroke/*pathology

Figure

• 

  Figure 1 Estimated smoking cessation rates between the timely interventions and the conventional counseling groups. Success rate in smoking cessation were compared using generalized estimating equation model. At each follow–up period, the timely interventions group showed significantly higher estimated smoking cessation rate compared with the conventional counseling group (*), except at 12 months. Most failure occurred during the first month after discharge in both groups (†). Error bars are standard errors of estimated smoking cessation rates.

• 

  Figure 2 Kaplan–Meier survival analysis between the timely interventions group and the conventional counseling group. The timely interventions group showed higher likely to be successful in smoking cessation during follow–up compared to the conventional counseling group (log–rank test, p= .002, hazard ratio 2.17, 95% CI, 1.30~3.60).

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