Psychosocial and behavioral characteristics of still smokers at 6 months after acute cerebro or cardiovascular events: preliminary findings from INEV@L, a prospective pilot study

Abstract

Introduction: Considering the benefits of smoking cessation, and evolving new tobacco-product consumption, such as e-cigarettes (e-cig), contemporary behavioral and psychosocial factors (PSF) associated with smoking after acute stroke or myocardial infarction (MI) remain to be investigated. Method(s): From INEV@L, a prospective pilot study in 128 workers hospitalized for MI or stroke (MI/stroke: 199/57) <65 y, between 2016 and 2017 in CHU Dijon. Among them, 67 (52%) current smokers were analyzed. PSF (education level (EL), socioeconomic status (SES), perceived disease severity (PDS), anxiety/depression), and health behavior (adhesion to Mediterranean diet (AMD), BMI, physical activity (PA), smoking) were collected at the acute phase and at 6 Months Follow-Up. Patients who quit smoking were compared with non-quitting patients. Result(s): Still smokers at 6-M FU were frequent (30 (45%)) and had similar risk factors including age (51+/-7 y) than quitters. Rate of overweight/obese patients and AMD were similar (52 vs 65%, p=0.281 and 29+/-6 vs 26+/-7, p=0.207). SES and EL were slightly higher in still smokers group. The level of anxiety or depression was as high in the 2 groups (63 vs 68%, and 19 vs 20%, p=0.717 and 0.911). Although similar at the acute phase (p=0.867), PDS at 6-M FU, trended to be lower in non-quitters (57 vs 78%, p=0.057). At FU, only few returned to work (57% for both groups). Overweight/obese who reduced their weight were more common in non-quitters (60 vs 38%, p=0.170). Patients who improved AMD or PA level were similar (62 vs 78%, p=0.166, and 67 vs 92%, p=0.317). The vast majority of non-quitters introduced the use of e-cig (80% vs 0%, p<0.001). Conclusion(s): Our pilot study in young workers highlights the low rate of smoking cessation, and generalized dual use of electronic+conventional cigarette at mid-term after acute MI or stroke. Our findings further suggest specific PSF pattern of non-quitters, associated with loss of perceived disease severity.