Risk factors for smoking abuse after heart transplantation

Basile, A; Bernazzali, Sonia; Diciolla, Francesco; Lenzini, F; Lisi, Gianfranco; Maccherini, Massimo; Mangini, V; Nesti, E; Chiavarelli, Mario

doi:10.1016/j.transproceed.2004.02.054

Cited by 29 publications

(29 citation statements)

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“…The rate of tobacco recidivism in this sample of 37.5% was slightly higher than the 17.6% to 32.5% reported in prior research. [6][7][8]13 We found that rates of tobacco use were higher among African American women than other ethnic groups. While no previous studies have examined racial differences in smoking behaviors among women following HTX, our findings concur with studies examining racial differences in smoking behaviors pre-HTX which show that smoking among African Americans was also significantly higher compared with Hispanics and Caucasians in a sample of women with chronic heart failure.…”

Section: Discussionmentioning

confidence: 82%

“…Data from a study conducted in Europe showed that lower perceptions of control were more significant in ex-smokers than nonsmokers, and that worse psychosocial adaptation was found among ex-smokers who ceased smoking <1 year before HTX compared with ex-smokers who stopped smoking more than a year before HTX. 7 The negative impact of tobacco use on health perceptions and health outcomes following HTX reinforces the need for health care providers to assess smoking status and ESHS in their patients, and to begin appropriate interventions aimed at enhancing patient adherence to smoking cessation recommendations both before and after HTX. Aggressive screening protocols to identify women at risk for tobacco abuse post-HTX are of utmost importance.…”

Section: Discussionmentioning

confidence: 99%

“…Investigators who specifically examined length of time of smoking cessation before HTX have reported that patients who have decided to stop smoking long before being considered for HTX had stronger convictions to adapt a healthier lifestyle and eliminate risks to their own health, while patients who stopped within the year before HTX did so because of worsening prognosis and desire to be placed on the transplantation wait list. 7,18 Additional studies to examine known causes for increased recidivism among patients who stop smoking shortly before HTX are warranted to better explicate this phenomenon.Surprisingly, we found that almost half of the nonsmokers were ESHS. Second-hand tobacco smoke is known to increase risks of acute myocardial infarction, sudden cardiac death, stroke, aortic aneurysm, and peripheral vascular disease among healthy adults secondary to both the prothrombotic and atherogenic effects of harmful chemicals and carcinogens that are released into the environment when people are smoking.…”

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confidence: 99%

“…Increased scrutiny among African American men and women who stopped smoking shortly before HTX is warranted given the data that timing of smoking cessation influences tobacco abuse postoperatively in HTX patients. 6,7 Interventions targeted at reducing smoking recidivism through lifestyle and behavioral changes need to be integrated into the overall management of the HTX patient. Patients at risks for recurrent smoking post-HTX need to be encouraged to attend compliance programs for tobacco avoidance.…”

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confidence: 99%

“…[6][7][8][9] The current study was conducted to describe tobacco use, exposure to second hand smoke (ESHS), and health perceptions of female HTX recipients. A secondary aim was to examine the association between tobacco use, ESHS, health perceptions, and women's demographic and clinical characteristics.…”

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confidence: 99%

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Smoking among Women Following Heart Transplantation: Should We Be Concerned?

Evangelista¹,

Ter-Galstanyan²

2009

Journal of Cardiac Failure

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The serious detrimental effects of smoking after heart transplantation (HTX) are well established, but data that demonstrate the effects on female HTX recipients are scarce. The purpose of this study was to describe tobacco use, exposure to second hand smoke (ESHS), and health perceptions of female HTX recipients and examine relationships between these variables of interest and demographic and clinical characteristics of women following HTX. Seventy-two women (mean age, 54.3 ± 12.7 years; mean time since transplant, 5.5 ± 4.5 years) were enrolled from a single HTX center. Demographic and clinical data, tobacco use, ESHS, and health perceptions were obtained through self-report and chart reviews. Tobacco use was verified by measurement of urine cotinine levels. Twenty-four women were nonsmokers before and after HTX. Eighteen (37.5%) of the 48 women who were former smokers before HTX had returned to tobacco abuse. Only 4 of the 18 accurately reported their smoking behaviors. Forty percent of nonsmokers reported ESHS. Tobacco use and ESHS were highest among African American women. Forty percent of the sample perceived their health status as fair-poor; the remaining 60% reported good-excellent health. In a multivariate analysis, current tobacco use (odds ratio [OR], 5.20; confidence interval [CI], 3.83-9.13) and ESHS (OR, 1.82; CI, 1.17-2.82) were independent predictors of lower health perceptions. Although a majority of the female recipients who used tobacco ceased smoking before HTX, a substantial proportion demonstrated recurrent tobacco use after HTX. Our findings suggest the need for aggressive screening and risk factor interventions to promote smoking cessation before and after HTX in this unique population of female HTX recipients.Almost 5000 heart transplantations (HTX) were done in the United States between 2006 and 2007; approximately 26% of HTX patients were women. 1 Although an increasing number of women need and receive HTX, little is known about their health risk behaviors after HTX. In the last decade, investigators have reported poorer overall outcomes in women than men, 2 and although both men and women have equivalent survival rates in the first year after HTX, the survival rates for women drop drastically thereafter. 1 Unfortunately, mechanisms underlying gender differences in survival are poorly understood and the effect of health risk behaviors like smoking on outcomes in women is unclear. Although the serious detrimental effects of smoking are well established in the general postheart HTX population, [3][4][5][6] there is a paucity of research examining its impact on female HTX recipients. METHODS Study Design and ParticipantsA cross sectional, correlational design was used. A convenience sample of 72 women who received follow-up care from a single-outpatient post-HTX clinic was recruited for the study. Women were eligible to participate if they received their HTX at least 1 year before enrollment but not >5 years after HTX. The ability to read, write, and speak English, and willingnes...

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Smoking among Women Following Heart Transplantation: Should We Be Concerned?

Evangelista¹,

Ter-Galstanyan²

2009

Journal of Cardiac Failure

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Tobacco and Cardiovascular Disease: Achieving Smoking Cessation in Cardiac Patients

Pipe

2009

Evidence‐Based Cardiology

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Smoking behavior in liver transplant recipients

et al. 2009

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Long-term morbidity and survival after orthotopic liver transplantation (OLT) are to a large degree determined by cardiovascular disease and cancer. Tobacco use is a well-known risk factor for both. The aim of this study was to examine smoking behavior before and after OLT and to define groups at risk for resuming tobacco use after OLT. In addition, we looked for a relation between smoking and morbidity after OLT. All 401 adult patients with a follow-up of at least 2 years after OLT were included. Data were collected from the charts. A questionnaire about smoking habits at 4 time points before and after OLT was sent to all 326 patients alive, and 301 (92%) patients responded. Both before and after OLT, 53% of patients never used tobacco, and around 17% were active smokers. Of the active smokers during the evaluation for OLT, almost one-third succeeded in cessation, often during the waiting time for OLT. Twelve percent of former smokers restarted smoking, mainly after OLT. Tobacco use was the highest in patients with alcoholic liver disease (52% were active smokers before OLT, and 44% were after OLT) and the lowest in patients with primary sclerosing cholangitis (1.4% were active smokers before OLT). At 10 years, the cumulative rate of malignancies was 12.7% in active smokers versus 2.1% in nonsmokers (P ϭ 0.019). No effect on skin cancer or cardiovascular disease was found. In conclusion, smoking is a serious problem after OLT and increases the risk for malignancy. Prevention programs should focus not only on active smokers but also on former smokers. Liver Transpl 15: 648-655, 2009.

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Risk factors for smoking abuse after heart transplantation

Cited by 29 publications

References 1 publication

Smoking among Women Following Heart Transplantation: Should We Be Concerned?

Smoking among Women Following Heart Transplantation: Should We Be Concerned?

Tobacco and Cardiovascular Disease: Achieving Smoking Cessation in Cardiac Patients

Smoking behavior in liver transplant recipients

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