Smoking cessation interventions for patients with coronary heart disease and comorbidities: an observational cross-sectional study in primary care

Blane, D. N., Mackay, D., Guthrie, B. and Mercer, S. W. (2017) Smoking cessation interventions for patients with coronary heart disease and comorbidities: an observational cross-sectional study in primary care. British Journal of General Practice, 67(655), e118-e129. (doi:10.3399/bjgp16X688405) (PMID:27919936)

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Abstract

Background: Little is known about how smoking cessation practices in primary care differ for patients with coronary heart disease (CHD) who have different comorbidities. Aim: To determine the association between different patterns of comorbidity and smoking rates and smoking cessation interventions in primary care for patients with CHD. Design: and setting Cross-sectional study of 81 456 adults with CHD in primary care in Scotland. Method: Details of eight concordant physical comorbidities, 23 discordant physical comorbidities, and eight mental health comorbidities were extracted from electronic health records between April 2006 and March 2007. Multilevel binary logistic regression models were constructed to determine the association between these patterns of comorbidity and smoking status, smoking cessation advice, and smoking cessation medication (nicotine replacement therapy) prescribed. Results: The most deprived quintile had nearly three times higher odds of being current smokers than the least deprived (odds ratio [OR] 2.76; 95% confidence interval [CI] = 2.49 to 3.05). People with CHD and two or more mental health comorbidities had more than twice the odds of being current smokers than those with no mental health conditions (OR 2.11; 95% CI = 1.99 to 2.24). Despite this, those with two or more mental health comorbidities (OR 0.77; 95% CI = 0.61 to 0.98) were less likely to receive smoking cessation advice, but absolute differences were small. Conclusion: Patterns of comorbidity are associated with variation in smoking status and the delivery of smoking cessation advice among people with CHD in primary care. Those from the most deprived areas and those with mental health problems are considerably more likely to be current smokers and require additional smoking cessation support.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Blane, Dr David and Mackay, Dr Daniel and Mercer, Professor Stewart
Authors: Blane, D. N., Mackay, D., Guthrie, B., and Mercer, S. W.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:British Journal of General Practice
Publisher:Royal College of General Practitioners
ISSN:0960-1643
ISSN (Online):1478-5242
Published Online:06 December 2016
Copyright Holders:Copyright © 2016 British Journal of General Practice
First Published:First published in British Journal of General Practice 67(655):e118-e129
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
477971Living Well with Multiple MorbidityStewart MercerScottish Executive Health Department (SEHHD-CSO)ARPG/07/1IHW - GENERAL PRACTICE & PRIMARY CARE