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smoking cessation, hostility, coronary artery disease, symptoms of distress



  1. Brummett, Beverly H. PhD
  2. Babyak, Michael A. PhD
  3. Mark, Daniel C. MD
  4. Williams, Redford B. MD
  5. Siegler, Ilene C. PhD, MPH
  6. Clapp-Channing, Nancy RN, MPH
  7. Barefoot, John C. PhD


PURPOSE: This study aimed to examine demographic, psychosocial, and clinical variables as predictors of smoking cessation in patients with coronary artery disease.


METHODS: Smoking status and psychosocial variables were obtained at baseline. Participants were followed up at 3 months then annually up to 6 years for smoking status. Participants were recruited from the population of patients undergoing coronary angiography from 1986 through 1990. Patients were included in the study if they reported smoking at baseline and had valid data for demographic and clinical measures of interest. Depending on the psychosocial measure analyzed, sample size ranged from 525 to 303. Age, gender, education, marital status, disease severity, cardiac procedure, hostility, and four ratings of distress were evaluated as predictors of smoking cessation.


RESULTS: Of the full sample, 40% (n = 210) quit smoking without relapse. Education (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.44-0.84;P < .003), disease severity (OR 0.58; 95% CI 0.40-0.84;P < .004), and coronary artery bypass surgery (OR 0.60; 95% CI 0.43-0.85;P < .004) were associated with a lower likelihood of relapse. Higher levels of hostility (OR 2.36; 95% CI 1.46-3.84;P < .001), concern about health (OR 1.90; 95% CI 1.33-2.74;P < .001), tension (OR 1.60; 95% CI 1.12-2.30;P < .012), and depressive feelings (OR 1.60; 95% CI 1.12-2.27;P < .010) were associated with a higher risk of continuing to smoke.


CONCLUSIONS: These findings describe demographic, clinical, and psychological mechanisms that might underlie successful smoking cessation and also may guide the identification of patients in need of special intervention.