Status And Factors Of Smoking Relapse Of The Patient With Coronary Heart Disease In One Year After Percutaneous Coronary Intervention

BackgroundPercutaneous coronary intervention(PCI)is one of the most widely used treatments for CHD.However,the procedure could only ensure the coronary artery unobstructed,but not get rid of the risk factors.One reason why the mortality of CHD is still high is that the risk factors of the disease have not been effectively controlled.Smoking is the first risk factor for mortality of CHD,which could remarkably increase the risk for stent thrombosis and mortality after PCI.The identification of the characteristics and factors of smoking relapse are helpful to the intervention of smoking cessation.But the features and factors of smoking resumption of the post-PCI patients have not been reported.AimsThis study was to investigate the incidence of smoking relapse of 1 year in the patients with CHD who quit smoking during PCI,and to identify the characteristics and predictors of smoking relapse.MethodsConvenience sampling was used to select the CHD patients who stopped smoking during PCI.The study investigated the demographics,medical history,smoking behavior,and psychological-cognitive characteristic of the participants.The questionnaires used in the survey included the Fagerstrom Test for Nicotine Dependence(FTND),Center for Epidemiologic Studies-Depression scale(CES-D),and Smoking Self-Efficacy Questionnaire(SEQ-12).Smoking relapses were reported by the patients and families at 3,6,9,12 months after PCI through telephone.ResultsA total of 221 patients who quit smoking during PCI completed the whole study.During 1 year after PCI,51.1%(n=113)of the patients relapsed to smoking,and 48.9%(n=108)achieved abstinence.Nearly half of the relapse(n=56)occurred in the first three months,and then the prevalence showed a more gradual increase.Employment,nicotine dependence and depression were positively correlated to smoking relapse.The patients who were currently employed experienced a nearly three-times higher risk of smoking relapse in comparison with those who were not currently employed(OR:2.98,95%Cl:1.15～7.73).The patients who were more nicotine dependent were more likely to return to smoking than the less dependent(OR:1:23,95%CI:1.03～1.46).The patients with depression were more likely to resume smoking than the patients without(OR:1.14,95%CI:1.05～1.24).In addition,smoking self-efficacy was negatively correlated with smoking relapse(OR:0.94,95%CI:0.91～0.97),the patients with higher levels of smoking self-efficacy were less vulnerable to restart smoking.ConclusionsThe incidence of smoking relapse of 1 year is high in the patients with CHD who quit smoking during PCI.The patients are at high risk of relapse in 3 months,which is the optimal time for intervention.The predictors of smoking relapse are employment,nicotine dependence,depression,and smoking self-efficacy in the post-PCI patients.It’s necessary to assess the risk of smoking relapse when offering intervention,and targeted instruction and assistance of smoking cessation should be provided to the patients at higher risk for restarting smoking.