Factors Associated with Smoking Cessation in Patients with Coronary Artery Diseases According to Sex: Cohort of Smoking Cessation Services Data from France

TL;DR

This study examines factors linked to smoking cessation in men and women with heart disease in France, finding that success factors differ by sex.

Contribution

The study identifies sex-specific factors associated with smoking cessation in patients with coronary artery disease.

Findings

Abstinence rates were similar for men and women, at 54%.

Women's success was linked to prior quit attempts and dual cigarette use.

Men's success was associated with employment, obesity, confidence, and nicotine replacement therapy.

Abstract

In smokers with coronary artery diseases (CADs), smoking cessation (SC) is a major prevention goal. From the French national database of SC services (SCSs), CDTnet, we aimed to describe the social, medical, and smoking characteristics of smokers with CAD, as well as factors associated with their SC, according to sex.

A retrospective study was conducted of smokers with CAD included in the CDTnet from January 2001 to December 2018. Endpoints were abstinence and reduction of daily cigarette consumption. Abstinence was defined as SC maintained for ≥ 28 consecutive days, confirmed by a carbon monoxide measure in exhaled breath testing < 10 parties per million, and reduction was defined as at least a halving of consumption compared to consumption at the time of the first consultation. Sex stratification was performed.

Among 4532 smokers included, 21% were women, and their mean age was 55 years in both sexes. Nearly half smoked ≥ 20 cigarettes daily, and most (80%) received nicotine replacement therapy. The 28-day abstinence rate (54%) and reduction rate (24%) were similar in both sexes. Factors positively associated with SC in women were having made ≥ 1 previous quit attempt, and dual use of conventional and electronic cigarettes at the time of the first consultation. In men, being employed, being overweight or obese, being confident in quitting, and being prescribed nicotine replacement therapy at the first consultation were factors associated with success. Other cardiovascular and respiratory diseases were associated negatively with SC in both sexes.

Abstinence rates were similar for both sexes, with different factors associated with quit attempt results, according to sex, highlighting the need for tailored interventions that address the specific needs of men and women who intend to quit.

Figures