Cigarette smoking patterns following a cardiac event: Results from a national survey

The occurrence of a cardiac event may be considered an opportune moment to deliver smoking cessation interventions. Yet, much of what is known about smoking patterns following a cardiac event is derived from treatment studies or geographically limited samples. Our analysis is based the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative sample of U.S. adults aged 18+ interviewed in 2001 to 2002 (n=43,093) and reinterviewed in 2004 to 2005 (n=34,653). We identified 598 smokers at W1 that also had a cardiac event in the prior 12 months. Of these smokers (pop est. 3.3 million), 18.5% (pop est. 620,000) reported abstinence at the 3 year follow-up, and 27.4% (pop est. 919,000) reported a significant (e.g., >25%) reduction in quantity smoked. Following a cardiac event, older respondents were more likely to make positive behavioral changes in smoking patterns (i.e. cutting down or quitting) compared to younger respondents. Cutting down was more common than quitting for those younger than age 68. However, this pattern was reversed for those aged 68+, where respondents were more likely to report quitting than cutting down. The occurrence of a Major Depressive Disorder after the cardiac event significantly predicted a decreased likelihood of successful 3-year cessation. No effects were observed between anxiety disorders or levels of physical impairment and changes in smoking patterns. To increase rates of successful cessation following a cardiac event, these findings highlight the need for complementary clinical and public health interventions that are developmentally appropriate across the lifespan.