Smoking and cardiac rehabilitation participation: Associations with referral, attendance and adherence

Diann E. Gaalema, Alexander Y. Cutler, Stephen T. Higgins, Philip A. Ades

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Objective: Continued smoking after a cardiac event greatly increases mortality risk. Smoking cessation and participation in cardiac rehabilitation (CR) are effective in reducing morbidity and mortality. However, these two behaviors may interact; those who smoke may be less likely to access or complete CR. This review explores the association between smoking status and CR referral, attendance, and adherence. Methods: A systematic literature search was conducted examining associations between smoking status and CR referral, attendance and completion in peer-reviewed studies published through July 1st, 2014. For inclusion, studies had to report data on outpatient CR referral, attendance or completion rates and smoking status had to be considered as a variable associated with these outcomes. Results: Fifty-six studies met inclusion criteria. In summary, a history of smoking was associated with an increased likelihood of referral to CR. However, smoking status also predicted not attending CR and was a strong predictor of CR dropout. Conclusion: Continued smoking after a cardiac event predicts lack of attendance in, and completion of CR. The issue of smoking following a coronary event deserves renewed attention.

Original languageEnglish (US)
Pages (from-to)67-74
Number of pages8
JournalPreventive Medicine
Volume80
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Keywords

  • Adherence
  • Attendance
  • Cardiac rehabilitation
  • Dropout
  • Enrollment
  • Participation
  • Referral
  • Smoking
  • Smoking cessation

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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