Return to work remains one of the main issues in cardiac rehabilitation after AMI or CABG. If resumption is sufficiently emphasized, a high success rate can be achieved. This approach should include a psychosocial strategy starting already during hospitalisation.

The Dutch translation of the MRSS identified four factors and revealed acceptable validity and reliability. The adapted version of the translated scale as a component of the psychological assessment procedure in a smoking cessation treatment in Dutch-speaking areas should be implemented.

Validity and reliability of the MRSS were shown in a sample of pregnant smokers. Tension reduction was the most important reason for continued smoking, followed by pleasure and addiction. Although the score for nicotine dependence was low, addiction was an important reason for continued smoking during pregnancy; therefore, nicotine replacement therapy could be considered. Half of the respondents experienced depressive symptoms. Hence, it is important to identify those women who need more specialized care, which can include not only smoking cessation counselling but also treatment for depression.

Background: Patients with coronary heart disease often suffer from an impaired health-related quality of life (HRQoL). A healthier lifestyle not only extends individuals' lengths of life but might also improve their HRQoL. The aim of this study was to explore the relation between self-reported lifestyle changes and HRQoL in European coronary patients. Methods: Data on 8745 coronary patients, from 22 countries, participating in the EUROASPIRE III survey (2006)(2007) were used. These patients hospitalized for coronary artery bypass graft, percutaneous coronary intervention, acute myocardial infarction, or myocardial ischaemia were interviewed and examined at least 6 months and no later than 3 years after their hospital admission to gather information on their HRQoL, self-reported lifestyle changes, and risk factors. Results: Significantly better HRQoL scores were found in ex-smokers compared to current smokers. Patients who made an attempt to increase their physical activity level had a better HRQoL compared to those who had not made an attempt. Furthermore dietary changes were associated with HRQoL, with better outcomes in patients who tried to reduce fat and salt intake and increase fish, fruit, and vegetable intake. The intention to change behaviour was not associated with HRQoL. Conclusions: Better HRQoL scores were found in those coronary patients who adopted a healthier lifestyle. The actual lifestyle changes -smoking cessation, increasing physical activity, and adopting a healthy diet -and not the intention to change are associated with better HRQoL outcomes.

These findings suggest that training in communication skills and dealing with resistance should be offered, i.e. by using motivational interviewing. It could be considered that a trained midwife or tobaccologist is part of an obstetrical team or that the AAR-method (Ask-Advise-Refer) is used instead of the 5 A's framework.