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Smoking Cessation in Women at the Time of an Invasive Cardiovascular Procedure and 3 Months Later

Moore, Leslie C. PhD, RN, MBA; Clark, Patricia C. PhD, RN, FAHA, FAAN; Lee, Shih-Yu PhD, RNC; Eriksen, Michael ScD; Evans, Kimberly MSN, RN; Smith, Cassie H. BSN, RN

The Journal of Cardiovascular Nursing: November/December 2013 - Volume 28 - Issue 6 - p 524–533
doi: 10.1097/JCN.0b013e31826620d4
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Background: Female smokers with coronary heart disease (CHD) are at an increased risk for negative health effects. The time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions.

Objective: The purpose of this study guided by the Health Belief Model was to determine which factors predict smoking cessation (SC) in women after an invasive CV procedure.

Methods: A correlational, prospective design was used. Data were collected from female smokers at the time of an invasive CV intervention (baseline) and 3 months later. Instruments measured commitment to stop smoking, perceived threat of CHD and future interventions, cessation self-efficacy, barriers to SC, benefits of SC, cues to action, and motivation. Analyses included χ2 and t tests and multiple, hierarchical, and logistic regression.

Results: On average, women (N = 76) were middle aged (mean [SD] age, 55.9 [8.0] years), smoked 15.3 (9.8) cigarettes per day, and on average smoked for 33.6 (10.2) years. At baseline, fewer perceived barriers to SC, high cessation self-efficacy, and being more autonomously motivated to quit smoking explained 67% of variance in commitment to stop smoking (P < .001). At 3 months, of 54 women responding, only 8 had quit smoking. Women reported smoking fewer cigarettes per day at 3 months compared with baseline (paired t51 = 3.43, P < .01). Higher baseline cessation self-efficacy and lower CHD threat were predictors of SC at 3 months (χ24 = 18.67, n = 54; P = .001).

Conclusions: Although commitment, motivation, and self-efficacy to stop smoking were high, perceived threat of CHD and future invasive CV interventions were high, and perceived barriers to SC were low, most women continued to smoke after their heart catheterization. Referrals for assistance from healthcare providers to decrease anxiety and nicotine dependence and to address ongoing challenges to SC are needed.

Leslie C. Moore, PhD, RN, MBA Assistant Professor, School of Nursing, Georgia College & State University, Milledgeville.

Patricia C. Clark, PhD, RN, FAHA, FAAN Professor, School of Nursing, Georgia State University, Atlanta.

Shih-Yu Lee, PhD, RNC Assistant Professor, School of Nursing, Georgia State University, Atlanta.

Michael Eriksen, ScD Professor and Director, Public Health Institute, Georgia State University, Atlanta.

Kimberly Evans, MSN, RN Student, School of Nursing, Georgia College & State University, Milledgeville.

Cassie H. Smith, BSN, RN Student, School of Nursing, Georgia College & State University, Milledgeville.

At the time of this work, the first author was a doctoral student in the Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta.

The authors have no funding or conflicts of interest to disclose.

Correspondence Leslie C. Moore, PhD, RN, MBA, Georgia College & State University, Milledgeville, GA, Campus Box 063, Milledgeville, GA 31061 (Leslie.Moore@gcsu.edu).

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins