Factors Influencing Successful Smoking Cessation after Acute Coronary Syndrome

Pavankumar Kamat


September 29, 2021



  • Most smokers with acute coronary syndrome (ACS) continue to smoke after hospital admission.

  • A meta-analysis identified factors influencing the likelihood of quitting smoking successfully and risk factors for smoking relapse.

Why this matters

  • Findings suggest that smoking cessation after ACS should be given the attention it deserves, in conjugation with other secondary prevention measures.

Study design

  • UK researchers conducted a meta-analysis of 39 studies (n=11,228), identified through a literature search across electronic databases.

  • Funding: None.

Key results

  • The pooled rate of smoking cessation after ACS was 45.0% (4824/10,726) across 38 studies.

  • Factors associated with a greater likelihood of smoking cessation were (OR; 95% CI):

    • attending cardiac rehabilitation (1.90; 1.44-2.51);

    • married/not alone (1.68; 1.32-2.13);

    • intention/attempt to quit smoking (1.27; 1.11-1.46);

    • diabetes mellitus (1.24; 1.03-1.51); and

    • longer duration of hospitalisation (1.09; 1.02-1.15).

  • Factors associated with a lower likelihood of smoking cessation were (OR; 95% CI):

    • depression (0.57; 0.43-0.75);

    • COPD/lung disease (0.73; 0.57-0.93);

    • previous admission with acute myocardial infarction/cardiac admission (0.61; 0.47-0.80);

    • cerebrovascular disease/TIA (0.42; 0.30-0.58); and

    • unemployment (0.37; 0.17-0.80).


  • Many studies were prospective in nature.

Lovatt S, Wong CW, Holroyd E, Butler R, Phan T, Patwala A, Loke YK, Mallen CD, Kwok CS. Smoking cessation after acute coronary syndrome: A systematic review and meta-analysis. Int J Clin Pract. 2021 Sep 19 [Epub ahead of print]:e14894. doi: 10.1111/ijcp.14894. PMID: 34541754. View abstract 


This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.



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