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Original Research

The Impact of Aversive Advice During Percutaneous Coronary Intervention on Smoking Cessation in Patients With Acute Coronary Syndrome

Authors:

Byung Sik Kim,

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
About Byung Sik
B.S. Kim and Y.-H. Lim contributed equally to the manuscript.
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Young-Hyo Lim,

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
About Young-Hyo
B.S. Kim and Y.-H. Lim contributed equally to the manuscript.
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Jeong Hun Shin,

Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri City, KR
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Seok Hyeon Kim,

Department of Psychiatry, Hanyang University Medical Center, Seoul, KR
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Sungwon Roh,

Department of Psychiatry, Hanyang University Medical Center, Seoul, KR
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Yeon Woo Choi,

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
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Jinho Shin,

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
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Jin-Kyu Park,

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
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Kyung-Soo Kim

Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, KR
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Abstract

Background: Smoking cessation is important to prevent recurrence of acute coronary syndrome (ACS), but even in patients with ACS, smoking is hard to quit.

Objectives: This study hypothesized that aversive advice during the percutaneous coronary intervention (PCI) procedure works effectively to promote smoking cessation in patients with ACS.

Methods: This study was conducted as a prospective, single-blinded, randomized controlled trial. A total of 66 patients were randomly assigned to an aversive advice group or a control group and instructed to visit the outpatient clinic 1, 4, and 24 weeks after discharge. In the aversive advice group, a physician who did not participate in the patient follow-up said the following 3 sentences to the patients during the PCI procedure: “Smoking caused your chest pain”; “If you do not stop smoking right now, this pain will come again”; and “The next time you feel this pain you will probably die.” All patients received usual advice on the importance of quitting smoking.

Results: At 24 weeks after discharge, the smoking cessation rate was higher in the aversive advice group than in the control group. In a multivariable logistic regression analysis, after adjustment for age, smoking quantity, alcohol consumption, and disease severity, the result was maintained (odds ratio = 4.47, 95% confidence interval: 1.50 to 13.34).

Conclusions: Aversive advice during a PCI procedure is effective at smoking cessation in patients with ACS. A physician’s attention and involvement during the PCI procedure improves the rate of smoking cessation in patients with ACS.

Highlights

  • Smoking cessation is important to prevent recurrence of ACS.
  • We hypothesized that aversive advice will promote smoking cessation in ACS patients.
  • Aversive advice during a PCI is effective at smoking cessation in ACS patients.
How to Cite: Kim BS, Lim Y-H, Shin JH, Kim SH, Roh S, Choi YW, et al.. The Impact of Aversive Advice During Percutaneous Coronary Intervention on Smoking Cessation in Patients With Acute Coronary Syndrome. Global Heart. 2019;14(3):253–7. DOI: http://doi.org/10.1016/j.gheart.2019.04.001
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Published on 01 Sep 2019.
Peer Reviewed

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