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Post-myocardial infarction smoking cessation counseling: associations with immediate and late mortality in older Medicare patients
Quantitative Health Sciences Publications and Presentations
  • Thomas K. Houston, University of Alabama
  • Jeroan J. Allison, University of Massachusetts Medical School
  • Sharina D. Person, University of Alabama
  • Stacey Kovac, University of Alabama
  • O. Dale Williams, University of Alabama
  • Catarina I. Kiefe, University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
Document Type
Aged; Directive Counseling; Epidemiologic Methods; Female; Humans; Male; Medicare; Myocardial Infarction; Smoking Cessation; Time Factors
PURPOSE: To assess the difference in immediate (30 and 60 days after admission) and late (2-year) mortality between those who received inpatient post-myocardial infarction smoking cessation counseling and those who did not receive counseling. METHODS: We conducted an observational study of a national random sample of inpatients from 2971 U.S. acute care hospitals participating in the Cooperative Cardiovascular Project in 1994-95. Medicare beneficiaries who were current smokers over age 65, admitted with a documented acute myocardial infarction, and who were discharged to home were included (n=16743). Our main outcome measures were early (30-, 60-day) and late (1-, 2-year) mortality. RESULTS: Smoking cessation counseling was documented during their index hospitalization for 41% of patients. Compared with those not counseled, those who received inpatient counseling had lower 30-day (2.0% vs. 3.0%), 60-day (3.7% vs. 5.6%), and 2-year mortality (25.0% vs. 30%) (logrank P <0.0001). After adjustment for demographic characteristics, comorbid conditions, APACHE score, and receipt of treatments including aspirin, reperfusion, beta-blockers, and angiotensin-converting enzyme inhibitors, those receiving counseling were less likely to die within 1 year, but the effect was lost between 1 and 2 years [hazard ratio (HR) = 0.99 (0.91-1.10)]. The greatest reduction in relative hazard (19%) was seen within 30 days [HR = 0.81 (95% confidence interval 0.65-0.99)]. CONCLUSION: Immediate and long-term mortality rates were lower among those receiving inpatient smoking cessation counseling.
DOI of Published Version
Am J Med. 2005 Mar;118(3):269-75. Link to article on publisher's site
PubMed ID
Related Resources
Link to Article in PubMed
Citation Information
Thomas K. Houston, Jeroan J. Allison, Sharina D. Person, Stacey Kovac, et al.. "Post-myocardial infarction smoking cessation counseling: associations with immediate and late mortality in older Medicare patients" Vol. 118 Iss. 3 (2005) ISSN: 0002-9343 (Linking)
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