Elsevier

Heart & Lung

Volume 36, Issue 5, September–October 2007, Pages 339-347
Heart & Lung

Issues in pulmonary nursing
Beliefs about health, smoking, and future smoking cessation among South Korean men hospitalized for cardiovascular disease

https://doi.org/10.1016/j.hrtlng.2006.11.001Get rights and content

Background

A particularly high rate of smoking among South Korean men corresponds to high rates of cardiovascular disease.

Objectives

This study evaluated South Korean men hospitalized with cardiovascular disease to explore beliefs about the health benefits of smoking cessation, to determine smoking cessation intentions, and to identify factors associated with confidence in quitting smoking.

Methods

This was a cross-sectional, descriptive study.

Results

Of the study’s 97 participants, only 78% believed that smoking cessation avoids or decreases the chance of developing heart disease; 93% reported their intention to quit; 74% had moderate to high confidence about quitting within the month after hospital discharge; and 88% preferred to quit by themselves without help. Significant predictors of low confidence in quitting were being married (odds ratio: 5.54, 95% confidence interval: 1.33–23.08); being alcohol dependent (odds ratio: 3.25, confidence interval: 1.20–8.80); and starting to smoke at or before 20 years of age (odds ratio: 2.96, confidence interval: 1.14–7.68).

Conclusion

The study’s participants were motivated to quit smoking for their health, but they must be educated to understand that smoking is addictive and that special intervention is needed.

Section snippets

Design and Methods

This is a cross-sectional, descriptive study. A convenience sample of participants was recruited from two university hospitals in South Korea. Men were included in the study if they (1) were 18 years of age or older; (2) were diagnosed with CVD, including coronary heart disease (angina pectoris, unstable angina, or myocardial infarction), heart failure, valve abnormalities, or peripheral arterial disease; (3) had a history of tobacco use within the past month; and (4) had been hospitalized in a

Results

Data collection began in January 2004 and ended in August 2004. The study participants consisted of 97 South Korean men (mean age, 54.1 ± 9.6 years) who were hospitalized with CVD. Most of the men had graduated from high school or had completed additional education, were married, and were employed full time (Table I). After reviewing the distribution of responses, the researchers combined the options very likely and likely; very unlikely and unlikely; strongly agree and agree; and strongly

Discussion

Smoking is not only the single most important and preventable risk factor for CVD but also equally important for people already diagnosed with CVD.45 The men in this study were not knowledgeable enough about the health hazards of smoking-related diseases. The researchers were intrigued by several observations.

First, only 78% of the participants believed that smoking cessation would help them avoid or decrease the chance of developing heart disease. This number is lower than 82% of men and women

Limitations

This study has several limitations. A cross-sectional design and a convenience sample were used, precluding reliable, causal associations to be drawn, and generalizability is limited. Because the data were collected during hospitalization, while patients were under medical supervision, the patients’ strong intention to quit smoking might have resulted from their wish to give socially desirable answers on their questionnaires. Actual smoking cessation attempts after participants were discharged

Conclusion

On the basis of these conclusions, it is recommended that South Korean patients be educated to realize that special intervention is needed because smoking is addictive. Future research must include South Korean women who are smokers and should evaluate the harmful effects and the benefits of the herbal smoking substitute, Eucommia ulmoides, as a quitting aid for patients with CVD. To explore the natural history of smoking behavior in this population and to minimize the effect of socially

References (57)

  • K. Emmons et al.

    Smokers who are hospitalized: a window of opportunity for cessation interventions

    Prev Med

    (1992)
  • R. Mahrer-Imhof et al.

    Women’s Initiative for Nonsmoking (WINS V): under-use of nicotine replacement therapy

    Heart Lung

    (2002)
  • K.M. Emmons et al.

    Smokers who are hospitalized: a window of opportunity for cessation interventions

    Prev Med

    (1992)
  • Survey on the smoking prevalence: the Korea Gallup Report

    (2003)
  • Annual report on the cause of death statistic

    (2003)
  • R. Mulcahy et al.

    Factors influencing long-term prognosis in male patients surviving a first coronary attack

    Br Heart J

    (1975)
  • J. Salonen

    Stopping smoking and long-term mortality after acute myocardial infarction

    Br Heart J

    (1980)
  • L. Daly et al.

    Long term effect on mortality of stopping smoking after unstable angina and myocardial infarction

    Br Med J

    (1983)
  • S. Johansson et al.

    Cessation of smoking after myocardial infarction in women

    Am J Epidemiol

    (1985)
  • J. Deckers et al.

    Quitting smoking in patients with recently established coronary artery disease reduces mortality by over 40%: results of a meta-analysis

    Eur Heart J

    (1994)
  • R. Mulcahy

    Influence of cigarette smoking on morbidity and mortality after myocardial infarction

    Br Heart J

    (1983)
  • D. Twardella et al.

    Short-term benefit of smoking cessation in patients with coronary heart disease: estimates based on self-reported smoking data and serum cotinine measurements

    Eur Heart J

    (2004)
  • B. Unal et al.

    Modelling the decline in coronary heart disease deaths in England and Wales, 1981–2000: comparing contributions from primary prevention and secondary prevention

    BMJ

    (2005)
  • N. Miller et al.

    Smoking cessation in hospitalized patientsResults of a randomized trial

    Arch Intern Med

    (1997)
  • C. Taylor et al.

    A nurse-managed smoking cessation program for hospitalized smokers

    Am J Public Health

    (1996)
  • E. Sivarajan Froelicher et al.

    Efficacy of smoking cessation intervention in women hospitalized with cardiovascular disease (CVD): Women’s Initiative for Nonsmoking (WINS)

    Circulation

    (2002)
  • N. Rigotti et al.

    Efficacy of a smoking cessation program for hospital patients

    Arch Intern Med

    (1997)
  • E.S. Sivarajan et al.

    Limited effects of outpatient teaching and counseling after myocardial infarction: a controlled study

    Heart Lung

    (1983)
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    Funding sources: Century Club Fund and Graduate Research Fund, University of California, San Francisco, California.

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