# Assessment of smoking cessation outcomes in patients with cardiovascular disease: A retrospective cohort study from Türkiye

## TL;DR

This study examines how successful patients with heart disease are at quitting smoking and finds that older age and treatment adherence are linked to better outcomes.

## Contribution

The study provides new insights into smoking cessation success among patients with cardiovascular disease in a Turkish population.

## Key findings

- Overall smoking cessation success was 16.7%, with 17.2% success in patients with cardiovascular disease.
- Older age and treatment completion were significantly associated with higher cessation success.
- Behavioral counseling alone showed the highest success rate (25.0%) among patients with cardiovascular disease.

## Abstract

Cardiovascular disease (CVD) is a major preventable cause of mortality, and smoking cessation significantly reduces the risk of recurrent cardiovascular events. However, many patients continue smoking despite their CVD diagnosis. This study aims to evaluate the impact of CVD and associated factors on smoking cessation success in patients who attempted to quit smoking at least one year ago.

This retrospective cohort study included patients who applied to the Smoking Cessation Clinic (SCC) between 1 May 2022 and 30 April 2023. A total of 539 eligible patients were analyzed. Data on demographics, CVD status, Fagerström test for nicotine dependence score, treatment modality (bupropion, nicotine replacement therapy, behavioral counseling), and smoking cessation outcomes were collected from medical records and confirmed via telephone interviews. Smoking cessation success was defined as complete abstinence after one year.

Among the participants, 145 (26.9%) had a history of CVD. The overall self-reported smoking cessation success rate after one year was 16.7%, and 17.2% in the CVD group. Bupropion users had significantly higher treatment completion rates (p=0.015). Multivariable logistic regression analysis revealed that older age (AOR=1.03; 95% CI: 1.01–1.05), higher level of education (AOR=1.84; 95% CI: 1.03–3.26), lower nicotine dependence score (AOR=0.85; 95% CI: 0.77–0.94), and treatment completion (AOR=0.13, 95% CI: 0.07–0.23) were significantly associated with smoking cessation success in the total sample. Among patients with CVD, older age (AOR=1.06; 95% CI: 1.01–1.12) and treatment completion (AOR=0.15; 95% CI: 0.05–0.43) were also associated with higher cessation success. Patients with CVD were more likely to receive non-pharmacological interventions, and behavioral counseling alone showed the highest success rate (25.0%).

Older age and treatment adherence were significantly associated with smoking cessation success, yet overall cessation rates remained low. A CVD diagnosis alone did not significantly enhance success, highlighting the need for tailored behavioral support and structured follow-up. Optimizing cessation programs with individualized interventions may improve outcomes, particularly in high-risk CVD patients.