Predictors of Smoking Resumption After Acute Coronary Syndrome: A Prospective Study in Western Iran

 Despite the health benefits of smoking cessation on patients with cardiovascular diseases (CVDs), some resume smoking even after their discharge from hospital with acute coronary syndrome (ACS).

 This study aimed to determine the predictors of smoking resumption after ACS in western Iran.

 This prospective cohort study was performed on 175 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of ACS from January 2018 to December 2018. Data were collected by a trained interviewer using a checklist developed based on the study objectives. Differences between groups were evaluated by independent t-test, chi-square, and Fisher’s exact tests. The relationship between smoking resumption and predicting variables was assessed using univariate and multivariate logistic regression models (Forward LR).

 All participants were male with a mean age of 56.30 ± 8.91 (mean ± SD) years. Three months post-discharge, 137 (78.3%) patients quit smoking, and 38 (21.7%) patients resumed it. The patients who resumed smoking were more likely to be divorced (20.6% vs. 0.7%), unemployed or retired (73.7% vs. 63.5%), have smokers in household (86.8% vs. 50.4%), and have history of depression (52.7% vs. 20.4%) (P-values < 0.05). The independent predictors of smoking resumption were divorce (OR 4.2, 95% CI: 1.31 - 19.01), having smokers in household (OR 12.08, 95% CI: 3.45 - 40.81), and history of depression (OR 12.16, 95% CI: 3.68 - 39.04).

 Divorce, having smokers in household, and history of depression were identified as the independent predictors of smoking resumption in ACS patients. Those who have these characteristics should be viewed as having a high risk of smoking relapse and be provided with more support to quit smoking.