PREDICTORS OF SMOKING CESSATION AFTER PERCUTANEOUS CORONARY REVASCULARIZATION

Objective: To identify factors predictive of smoking cessation after s uccessful percutaneous coronary revascularization. Material and Method s: We undertook a case-control study of the smoking status of all pati ents at Mayo Clinic Rochester from September 1979 through December 199 5 who were smokers at the time of an index percutaneous coronary revas cularization procedure in the non-periinfarction setting (no myocardia l infarction within 24 hours), Maximal duration of prospective follow- up was 16 years, Patients were classified into those who permanently q uit smoking immediately after the procedure (N = 435; mean follow-up, 5.1 +/- 3.7 years) or those who continued to smoke at some time during follow-up (N = 734; mean follow-up, 5.3 +/- 3.7 years), Logistics reg ression models mere formulated to determine independent predictors of smoking cessation. Results: Predictors of continued smoking were great er prior cigarette consumption (odds ratio [OR] = 1.009 for each pack- year; 95% confidence interval [CI] = 1.004 to 1.014) and having one or more risk factors for coronary artery disease other than cigarette sm oking (OR = 1.49; 95% CI = 1.15 to 1.93), Older age (OR = 0.98 for eac h additional year; 95% CI = 0.97 to 0.99) and unstable angina at time of initial assessment (OR = 0.69; 95% CI = 0.52 to 0.91) were associat ed with less likelihood of continued smoking. Conclusion: Younger pati ents with a worse risk profile and greater prior cigarette consumption were more likely than other patients to continue smoking after percut aneous coronary revascularization in the non-periinfarction setting, P atients who had unstable angina were more likely to quit smoking than those who had stable angina, Despite the proven benefits of smoking ce ssation after percutaneous coronary revascularization, a substantial p roportion of smokers (63%) continue to smoke; thus, smoking-cessation counseling should be addressed in this population.