Factors Associated With Continued Smoking in Lebanese Patients With Acute Coronary Syndrome

BACKGROUND: Smoking in patients with acute coronary syndrome (ACS) increases their risk for recurrent events and death. OBJECTIVES: The aim of this study was to describe the smoking trajectory among patients hospitalized with ACS and associated factors. METHODS: Forty patients with ACS who were smokers were interviewed in the hospital about smoking history, nicotine dependence, depression, self-efficacy, and social support. Phone interviews at 1, 3, 6, and 12 months after discharge assessed smoking status and related factors. RESULTS: Most patients (≥80%) were middle-aged married men, with high nicotine dependence (52.5%) and low self-efficacy for smoking cessation (mean [SD], 38.3 [27.19]) at baseline. Although 85% intended to quit after discharge, 62.5% continued smoking after 1 year. Persistent smoking was associated with lower self-efficacy (P < .01) and higher depression (P = .025). CONCLUSION: Smoking cessation intervention must start in the hospital and continue for 6 months. The program must target self-efficacy, manage depression, and involve the patient's family.