Psychosocial and behavioral characteristics of still smokers at 6 months after acute cerebro or cardiovascular events: Findings from INEV@L, a prospective pilot study
Résumé
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.MethodsFrom 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 at FU.ResultsStill smokers at 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).ConclusionOur 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.