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Psychosocial interventions help people with coronary heart disease to quit smoking

Barth J, Jacob T, Daha I, et al. Psychosocial interventions for smoking cessation in patients with coronary heart disease. Cochrane Database Syst Rev. 2015;7:CD006886.

Review question

Do psychosocial interventions such as counselling and telephone support help smokers who have coronary heart disease to stop smoking?

Background

People who smoke are more likely to have coronary heart disease. Smokers with coronary heart disease are more likely to have cardiac events and die from cardiovascular disease. Stopping smoking can reduce the risk for heart attacks and death. Several treatments can help people to stop smoking, including written materials, brief advice, counselling, and medications.

How the review was done

The researchers did a systematic review, searching for studies published up to January 2013. They found 40 randomized controlled trials with 7928 people.

In the trials, people had coronary heart disease (heart attack, coronary artery bypass surgery, or percutaneous transluminal coronary angioplasty) and smoked. Average age ranged from 50 to 60 years and 70% to 90% of people in the trials were men.

Psychosocial interventions using counselling, motivational support, and advice to change smoking behaviour were compared with usual care for at least 6 months.

What the researchers found

37 trials measured smoking quit rates at 6 to 12 months, and 7 trials measured smoking quit rates at more than 1 year.

Interventions focused on smoking alone or also addressed other risk factors such as obesity, inactivity, and smoking.

Psychosocial interventions using behavioural therapy, telephone support, or self-help materials each increased smoking quit rates at 6 to 12 months compared with usual care.

At more than 1 year, there was no difference between groups in smoking quit rates.

Conclusion

In people with coronary heart disease who smoke, psychosocial interventions using behavioural therapy, telephone support, or self-help materials improve smoking quit rates at 6 to 12 months.

Psychosocial interventions vs usual care for quitting smoking in people with coronary heart disease

Psychosocial intervention

Time point

Number of trials (number of people)

Smoking quit rate with psychosocial intervention

Smoking quit rate with usual care

 

Effect of psychosocial intervention

All

6 to 12 months

37 trials (7682 people)

46%

37%

About 9 more people out of 100 quit smoking

Behavioural therapy

6 to 12 months

20 trials (5170 people)

42%

34%

About 8 more people out of 100 quit smoking

Telephone support

6 to 12 months

26 trials (5807 people)

46%

38%

About 8 more people out of 100 quit smoking

Self-help materials

6 to 12 months

18 trials (3789 people)

49%

40%

About 9 more people out of 100 quit smoking

All

More than 12 months

5 trials (854 people)

41%

37%

No difference in smoking quit rates*

*Although the rates for the 2 groups look a little different, the differences were not statistically significant. This means the difference could simply be due to chance rather than due to the different treatments.




Glossary

Coronary heart disease
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk factors
Aspects making a condition more likely.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.
Vascular
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.

Related Web Resources

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    Men over 40 and women past menopause or over 50 should get screened for coronary artery disease (CAD) every 1 to 3 years. Your risk is higher if you have diabetes, high blood pressure, abdominal obesity, kidney disease, family history of CAD or if you smoke.
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    Eat less saturated fats in your diet to help prevent heart disease. Eat less meat, butter, cheese and cream to improve your health long-term.
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