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Life Years Gained From Smoking-Cessation Counseling After Myocardial Infarction
University of Massachusetts Medical School Faculty Publications
  • Emily M. Bucholz, Yale School of Medicine
  • Adam L. Beckman, Yale College
  • Catarina I. Kiefe, University of Massachusetts Medical School
  • Harlan M. Krumholz, Yale School of Medicine
UMMS Affiliation
Department of Quantitative Health Sciences
Date
1-1-2017
Document Type
Article
Abstract

INTRODUCTION: Hospitalization for acute myocardial infarction (AMI) is an opportune time to counsel smokers to quit. Studies have demonstrated lower short-term mortality for counseled versus non-counseled smokers; yet, little is known about the long-term survival benefits of post-AMI smoking-cessation counseling (SCC).

METHODS: Data from the Cooperative Cardiovascular Project, a prospective cohort study of elderly patients with AMI between 1994 and 1996 with >17 years of follow-up, were used to evaluate the association of SCC with short- and long-term mortality in smokers with AMI. Life expectancy and years of potential life gained were used to quantify the long-term survival benefits of SCC. Cox proportional hazards models with exponential extrapolation were used to estimate life expectancy.

RESULTS: The analysis included 13,815 smokers, of whom 5,695 (41.2%) received SCC. Non-counseled smokers had higher crude mortality than counseled smokers over all 17 years of follow-up. After adjustment for patient and hospital characteristics, SCC was associated with a 22.6% lower 30-day mortality and a 7.5% lower mortality over 17 years. These survival differences produced higher life expectancy estimates for counseled smokers than non-counseled smokers at all ages, which resulted in average gains in life years of 0.13 (95% CI=-0.31, 0.56) to 0.58 (95% CI=0.25, 0.91) years, with the largest gains observed in older smokers.

CONCLUSIONS: SCC is associated with longer life expectancy and gains in life years in elderly smokers with AMI, supporting the importance of post-AMI counseling efforts.

Rights and Permissions
Citation: Am J Prev Med. 2017 Jan;52(1):38-46. Epub 2016 Sep 28. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
27692757
Citation Information
Emily M. Bucholz, Adam L. Beckman, Catarina I. Kiefe and Harlan M. Krumholz. "Life Years Gained From Smoking-Cessation Counseling After Myocardial Infarction" Vol. 52 Iss. 1 (2017) ISSN: 0749-3797 (Linking)
Available at: http://works.bepress.com/catarina_kiefe/264/