Diann E Gaalema1, Alexander Y Cutler2, Stephen T Higgins3, Philip A Ades4. 1. Vermont Center on Behavior and Health, University of Vermont, USA; Department of Psychiatry, University of Vermont, USA; Department of Psychology, University of Vermont, USA. Electronic address: dgaalema@uvm.edu. 2. Vermont Center on Behavior and Health, University of Vermont, USA; Department of Psychiatry, University of Vermont, USA. 3. Vermont Center on Behavior and Health, University of Vermont, USA; Department of Psychiatry, University of Vermont, USA; Department of Psychology, University of Vermont, USA. 4. Vermont Center on Behavior and Health, University of Vermont, USA; Department of Medicine, Division of Cardiology, University of Vermont Medical Center, USA.
Abstract
OBJECTIVE: Continued smoking after a cardiac event greatly increases mortality risk. Smoking cessation and participation in cardiac rehabilitation (CR) are effective in reducing morbidity and mortality. However, these two behaviors may interact; those who smoke may be less likely to access or complete CR. This review explores the association between smoking status and CR referral, attendance, and adherence. METHODS: A systematic literature search was conducted examining associations between smoking status and CR referral, attendance and completion in peer-reviewed studies published through July 1st, 2014. For inclusion, studies had to report data on outpatient CR referral, attendance or completion rates and smoking status had to be considered as a variable associated with these outcomes. RESULTS: Fifty-six studies met inclusion criteria. In summary, a history of smoking was associated with an increased likelihood of referral to CR. However, smoking status also predicted not attending CR and was a strong predictor of CR dropout. CONCLUSION: Continued smoking after a cardiac event predicts lack of attendance in, and completion of CR. The issue of smoking following a coronary event deserves renewed attention.
OBJECTIVE: Continued smoking after a cardiac event greatly increases mortality risk. Smoking cessation and participation in cardiac rehabilitation (CR) are effective in reducing morbidity and mortality. However, these two behaviors may interact; those who smoke may be less likely to access or complete CR. This review explores the association between smoking status and CR referral, attendance, and adherence. METHODS: A systematic literature search was conducted examining associations between smoking status and CR referral, attendance and completion in peer-reviewed studies published through July 1st, 2014. For inclusion, studies had to report data on outpatient CR referral, attendance or completion rates and smoking status had to be considered as a variable associated with these outcomes. RESULTS: Fifty-six studies met inclusion criteria. In summary, a history of smoking was associated with an increased likelihood of referral to CR. However, smoking status also predicted not attending CR and was a strong predictor of CR dropout. CONCLUSION: Continued smoking after a cardiac event predicts lack of attendance in, and completion of CR. The issue of smoking following a coronary event deserves renewed attention.
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