Determinants of intention to quit smoking among patients undergoing coronary angiogram in a tertiary health care centre in Malaysia / Farhani Samat

Introduction: Smoking affects all-cause mortality especially among patients with Coronary Artery Disease (CAD). Continued smoking after acquiring CAD leads to more cardiovascular events and invasive surgical intervention (PCI/CABG). Nevertheless, the prevalence of active smokers admitted for ACS and STEMI was relatively high (33% and 50%) . Various efforts are currently conducted by Government of Malaysia to reduce this smoking issue which includes smoking cessation. Smoking cessation before or after a Myocardial Infarction (MI) or CAD event is the most effective preventive measure to reduce total mortality regardless of the type of index cardiac event or years of having CAD. One of the predictors of smoking cessation is intention to quit, however, the prevalence of intention to quit among CAD population are limited. Literatures had proved that intention to quit predict abstinence rate among smokers with heart disease. Since intention to quit smoking is a critical stage of behavioural changes of smoking cessation, being aware of smokers‟ intention to quit and the related associated factors can provide considerable advantages in this population group. This study aimed to determine the prevalence of intention to quit smoking and its associated factors among patients who are undergoing coronary angiogram. Methodology: This is a cross-sectional study. Participants were recruited via consecutive sampling method. Sampling was performed in the period of six weeks from patients who were admitted electively for coronary angiogram in a tertiary health care centre. Intention to quit was assessed using Stage of Change Questionnaire, while FTND and CSEQ-12 questionnaires were used to assess nicotine dependence level and cessation self-efficacy. Data analysis was conducted using SPSS version 23. The factors influencing quit intention were assessed using bivariate regression and multiple logistic regression model. Result: There were 218 male smokers admitted in this study. Prevalence of intention to quit smoking was 57% [95% CI (50-64)]. Bivariate analysis showed significant association between cigarette consumption, FTND score, previous quit attempt and cessation self-efficacy (CSEQ) with quitting intention. There was no association found between background characteristic and intention to quit in this study. In the final multiple logistic regression model, two factors were found to be significantly associated with intention to quit smoking. These were previous quit attempt (OR=1.9; P=0.045) and cessation self-efficacy (OR=1.4; P=0.001). Conclusion: This study found that more than half of smokers admitted for coronary angiogram had an intention to quit and it is significantly associated with previous quit attempt and cessation self-efficacy. Understanding the associated factors can guide the clinicians to facilitate smoking cessation among patients based on individual approach. A targeted approach of smoking cessation intervention based on smokers‟ cessation self-efficacy level and quitting experience is recommended.