The effectiveness of a stage-matched smoking cessation intervention for cardiac patients: a randomized controlled trial

Abstract

Objective: To study the effectiveness of a stage matched intervention provided by nurses in motivating Chinese cardiac patients to quit smoking.

Methods: A randomized controlled trial conducted in the cardiac outpatient clinics of 10 major hospitals in Hong Kong. 1860 cardiac out-patient daily smokers were randomized to the intervention (n=938) and control (n=922). The intervention group received stage-matched smoking cessation counseling delivered by a trained nurse counselor, and a 1-week and 1-month telephone reminders. The control group received a placebo intervention on healthy diet education. All participants were follow-up at 3 and 6 months to assess the quit rate, cigarette consumption, and stages of readiness to quit.

Results: Majority of the subjects were male (91%) and 61% smoked not more than half a pack per day. Most were not ready to quit with 68% and 21% in the pre-contemplation and contemplation stage respectively. At 6-month follow up, the intervention group reported a significantly greater 7-day point prevalence quit rate than the control (27.8% vs 21.7%; p=.001). Significantly more participants in the intervention group reduced their cigarettes consumption by at least 50% (51.1% vs 39.8%; p<.01). More participants in the intervention group progressed to a higher stage of readiness to quit compared to the control (32% vs 28%; p=.07).

Conclusion This is the first RCT conducted on a Chinese cardiac population. The nurse-delivered stage-matched intervention was effective in motivating patients to quit smoking, reduce cigarette consumption, and progress to a higher stage of readiness to quit.

RGC Hong Kong (HKU7224/01M)