An Intervention to Address Secondhand Tobacco Smoke Exposure Among Nonsmokers Hospitalized With Coronary Heart Disease

Secondhand tobacco smoke (SHS) exposure increases nonsmokers' risk of coronary heart disease and worsens outcomes after hospitalization for acute coronary syndrome, but it is rarely addressed in inpatient cardiac care. We developed and assessed a hospital-based intervention to increase nonsmoke...

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Bibliographic Details
Published in:The American journal of cardiology 2014-10, Vol.114 (7), p.1040-1045
Main Authors: Rigotti, Nancy A., MD, Park, Elyse R., PhD, MPH, Streck, Joanna, BA, Chang, Yuchiao, PhD, Reyen, Michele, MPH, McKool, Kathleen, RN, MSN, Winickoff, Jonathan P., MD, MPH
Format: Article
Language:English
Subjects:
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Cardiovascular
Cardiovascular disease
Coronary Disease - epidemiology
Coronary Disease - prevention & control
Female
Follow-Up Studies
Heart attacks
Hospitals
Humans
Inpatients
Male
Massachusetts - epidemiology
Retrospective Studies
Risk Assessment - methods
Risk Factors
Tobacco smoke
Tobacco Smoke Pollution - adverse effects
Tobacco Smoke Pollution - prevention & control
Tobacco Smoke Pollution - statistics & numerical data
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Summary:Secondhand tobacco smoke (SHS) exposure increases nonsmokers' risk of coronary heart disease and worsens outcomes after hospitalization for acute coronary syndrome, but it is rarely addressed in inpatient cardiac care. We developed and assessed a hospital-based intervention to increase nonsmokers' awareness of SHS as a cardiovascular risk factor. Nonsmokers admitted to 2 cardiac units of a large Boston, Massachusetts, hospital were surveyed before (May 2010 to January 2011) and after (November 2011 to March 2012) a system-level nurse-delivered intervention was implemented in October 2011. It consisted of a revised admission form that prompted nurses to document SHS exposure at admission, provide a pamphlet about SHS risks, and advise nonsmokers to make their home and car smoke free. The primary outcome was patients' short-term recall of advice to keep their home and car smoke free. The secondary outcome was patients' awareness of the cardiovascular risk of SHS exposure. We enrolled 190 nonsmokers before and 142 nonsmokers after implementation. Adjusting for group differences, patients admitted after the system change were more likely to recall being asked if a household member smokes (24% vs 10%, adjusted odds ratio [AOR] 3.6, 95% confidence interval [CI] 1.8 to 7.1, p = 0.0002) and being advised to keep their home and car smoke free (28% vs 2%, AOR 27.3, 95% CI 7.8 to 95.7, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2014.07.017