Health beliefs and smoking patterns in heart patients and their wives: a longitudinal study.

Abstract

Smoking patterns of 205 male patients were examined over a period of eight years after a primary myocardial infarction. Smoking data from their wives at one year after the heart attack were also examined. A marked, persistent reduction in smoking was found among the men. Smoking patterns of wives remained essentially unchanged. Smoking patterns before the heart attack were not related to demographic variables, except for the association between smokernonsmoker status and social status measures. Conceptions of susceptibility, threat, and power of prevention Few studies of smoking behavior have reported on populations which achieved a twofold objective: elimination or marked reduction of smoking, and maintenance ofthis behavior change over an extended period. In experiments on changing health-related behavior, it often has been noted that prevention-oriented approaches are extremely difficult and that long-term successes are not easily achieved. Prevention efforts in such areas as caries reduction, hypertension, diet control in heart disease and in anti-smoking campaigns bear ample witness to this. [1][2][3][4] Recently, however, some degree of success in altering smoking behavior has been noted in a number of studies of post-cardiac patients. [5][6][7][8] In this paper we report on a study population of male cardiac patients whose level of smoking as a group was reduced and remained at a lower level eight or nine years after a primary myocardial infarction. In addition, we present data on the smoking patterns ofa population ofwomen-the wives of these patients-at one year following the first heart attack. The purposes are: a) to describe the smoking patterns of the patients over time; b) to examine the smoking patterns of the two groups at one year following the attack; c) to report on an exploration of social, demographic, and personality variables in relation to smoking behavior; and d) to view the long-term smoking patterns in terms of some conceptual notions employed in existing theoretical frameworks and hypotheses developed for explaining preventive health behavior.9-12Address reprint requests to Dr. Sydney H. Croog, Professor, Department of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington, CT 06032. This paper, submitted to the Journal November 24, 1976, was revised and accepted for publication March 3, 1977. drawn from theoretical models on preventive health behavior were employed for analysis. High proportions of husbands and wives reported belief in smoking as important in the etiology of the heart attack, and in possibilities of prevention. Specific beliefs concerning threat, susceptibility, and prevention were not found to be related to the massive drop in smoking behavior among the men nor to stability in pattern among the wives. Alternative explanations are reviewed. (Am J.Public Health 67: [921][922][923][924][925][926][927][928][929][930] 1977) Motivations for changes in smoking pattern have been the object of a massive effort of empirica...

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