Amsterdam University of Applied Sciences

Programme to stop smoking after heart attack ineffective

7 Sep 2018 11:05 | Communication

The care in relation to giving up smoking offered to smokers following a heart attack is not effective. Patients who have stopped by themselves need something completely different, and those continuing to smoke following a coronary need much more intensive support. These are the conclusions reached in the thesis by Marjolein Snaterse, a Nursing researcher at the Amsterdam University of Applied Sciences, who will receive her doctoral degree from Amsterdam UMC/UvA on Wednesday, 12 September.

The major recommendation to emerge from her research: organise care for patients who have had a heart attack differently, as it has been proven that this can be much more effective. Snaterse and her colleagues monitored 324 smokers who had heart attacks (in 15 hospitals in the Netherlands for a period of at least a year). Approximately half of these patients stopped smoking; slightly more than 50 percent continued smoking after the heart attack. “A considerable percentage”, Snaterse says. “The standard stop smoking programme following a coronary proved inadequate for them.”

People who have stopped smoking would prefer to lose weight

The research reveals that those who do give up cigarettes for good following a heart attack do not benefit from the stop smoking programme. The vast majority of patients who stop do so at their own initiative, immediately after the attack. It seems that they are able to do this by themselves, as a year later they have not relapsed.

Snaterse: “Based on these conclusions, we say: as a care provider, don’t be afraid to stop referring this group to a stop smoking programme, because these people don’t even want to be reminded that cigarettes exist. Most people who have stopped have already made the switch and this means they are motivated to tackle other issues. They would prefer to follow a weight-loss or exercise programme.”

Approach to giving up smoking is not working

A heart attack is the best motivation to stop smoking. The stop smoking programme on the other hand is aimed mainly at people who go back to smoking after being discharged from hospital – and the research shows that this has not led to more people stopping smoking. “The way we are doing it at the moment is not working”, Snaterse concludes.

In the stop smoking programme, a doctor tells the smoker who has had a heart attack that he or she has to stop smoking. A nurse will also have a number of conversations with the patient, including about changing unhealthy lifestyle habits and medication use, and the patient is referred to a stop smoking programme consisting of six mentoring telephone sessions.

Marjolein Snaterse

Smoking is not a choice

The stop smoking programme falls way short of what those people need who are unable to resist cigarettes after having a heart attack. Snaterse: “This group experience a great deal of stress concerning money, health and personal issues. These people say they do want to stop, but that cigarettes are very attractive to them because of the pressures they face. So, I conclude: smoking is not a choice. People who continue smoking after hospitalisation are addicted. We need to give these people more intensive treatment – potentially also in areas other than just a stop smoking programme.”