Arda Yagmur Gokseven, Ozturk Guzin Zeren
Department of Family Medicine, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye.
Tob Induc Dis. 2025 May 19;23. doi: 10.18332/tid/203867. eCollection 2025.
INTRODUCTION: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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.
引言：心血管疾病（CVD）是主要的可预防死亡原因，戒烟可显著降低心血管事件复发风险。然而，许多患者尽管被诊断患有心血管疾病仍继续吸烟。本研究旨在评估心血管疾病及相关因素对至少一年前尝试戒烟患者戒烟成功的影响。 方法：这项回顾性队列研究纳入了2022年5月1日至2023年4月30日期间申请戒烟诊所（SCC）的患者。共分析了539名符合条件的患者。从病历中收集人口统计学、心血管疾病状况、尼古丁依赖的法格斯特龙测试评分、治疗方式（安非他酮、尼古丁替代疗法、行为咨询）及戒烟结果数据，并通过电话访谈进行确认。戒烟成功定义为一年后完全戒烟。 结果：参与者中，145人（26.9%）有心血管疾病史。一年后总体自我报告的戒烟成功率为16.7%，心血管疾病组为17.2%。安非他酮使用者的治疗完成率显著更高（p = 0.015）。多变量逻辑回归分析显示，年龄较大（调整后比值比[AOR]=1.03；95%置信区间[CI]：1.01 - 1.05）、教育水平较高（AOR = 1.84；95% CI：1.03 - 3.26）、尼古丁依赖评分较低（AOR = 0.85；95% CI：0.77 - 0.94）以及治疗完成（AOR = 0.13，95% CI：0.07 - 0.23）与总样本中的戒烟成功显著相关。在患有心血管疾病的患者中，年龄较大（AOR = 1.06；95% CI：1.01 - 1.12）和治疗完成（AOR = 0.15；95% CI：0.05 - 0.43）也与更高的戒烟成功率相关。患有心血管疾病的患者更有可能接受非药物干预，仅行为咨询的成功率最高（25.0%）。 结论：年龄较大和治疗依从性与戒烟成功显著相关，但总体戒烟率仍然较低。仅心血管疾病诊断并未显著提高成功率，这突出了需要有针对性的行为支持和结构化随访。通过个性化干预优化戒烟计划可能会改善结果，特别是在高危心血管疾病患者中。
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