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coronary heart disease, health belief model, self-efficacy, smoking cessation, women



  1. Moore, Leslie C. PhD, RN, MBA
  2. Clark, Patricia C. PhD, RN, FAHA, FAAN
  3. Lee, Shih-Yu PhD, RNC
  4. Eriksen, Michael ScD
  5. Evans, Kimberly MSN, RN
  6. Smith, Cassie H. BSN, RN


Background: Female smokers with coronary heart disease (CHD) are at an increased risk for negative health effects. The time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions.


Objective: The purpose of this study guided by the Health Belief Model was to determine which factors predict smoking cessation (SC) in women after an invasive CV procedure.


Methods: A correlational, prospective design was used. Data were collected from female smokers at the time of an invasive CV intervention (baseline) and 3 months later. Instruments measured commitment to stop smoking, perceived threat of CHD and future interventions, cessation self-efficacy, barriers to SC, benefits of SC, cues to action, and motivation. Analyses included [chi]2 and t tests and multiple, hierarchical, and logistic regression.


Results: On average, women (N = 76) were middle aged (mean [SD] age, 55.9 [8.0] years), smoked 15.3 (9.8) cigarettes per day, and on average smoked for 33.6 (10.2) years. At baseline, fewer perceived barriers to SC, high cessation self-efficacy, and being more autonomously motivated to quit smoking explained 67% of variance in commitment to stop smoking (P < .001). At 3 months, of 54 women responding, only 8 had quit smoking. Women reported smoking fewer cigarettes per day at 3 months compared with baseline (paired t51 = 3.43, P < .01). Higher baseline cessation self-efficacy and lower CHD threat were predictors of SC at 3 months ([chi]24 = 18.67, n = 54; P = .001).


Conclusions: Although commitment, motivation, and self-efficacy to stop smoking were high, perceived threat of CHD and future invasive CV interventions were high, and perceived barriers to SC were low, most women continued to smoke after their heart catheterization. Referrals for assistance from healthcare providers to decrease anxiety and nicotine dependence and to address ongoing challenges to SC are needed.