Clinical Research
Peripheral Artery Disease
Effectiveness of a Smoking Cessation Program for Peripheral Artery Disease Patients: A Randomized Controlled Trial

https://doi.org/10.1016/j.jacc.2010.07.031Get rights and content
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Objectives

This study tested the effectiveness of a smoking cessation program designed for patients with peripheral artery disease (PAD).

Background

Tobacco use is the leading risk factor for PAD incidence and progression and for ischemic events. Tobacco cessation reduces PAD-related morbidity and mortality, yet few prospective clinical trials have evaluated smoking cessation interventions in PAD patients.

Methods

We recruited outpatients with lower extremity PAD identified from medical records as cigarette smokers. Participants were randomly assigned to an intensive tailored PAD-specific counseling intervention or a minimal intervention. Participants completed surveys at baseline and at 3- and 6-month follow-up. Reported 7-day point prevalent smoking abstinence was confirmed by cotinine or carbon monoxide assessment.

Results

In all, 687 outpatients were identified as probable smokers with lower extremity PAD; 232 met study eligibility requirements; and 124 (53% of eligible) enrolled. Participants were receptive to counselor contact: the median number of sessions was 8.5 (range 0 to 18). Participants randomly assigned to the intensive intervention group were significantly more likely to be confirmed abstinent at 6-month follow-up: 21.3% versus 6.8% in the minimal intervention group (chi-square = 5.21, p = 0.023).

Conclusions

Many long-term smokers with PAD are willing to initiate a serious quit attempt and to engage in an intensive smoking cessation program. Intensive intervention for tobacco dependence is a more effective smoking cessation intervention than minimal care. Studies should be conducted to examine the long-term effectiveness of intensive smoking cessation programs in this population to examine the effect of this intervention on clinical outcomes related to PAD.

Key Words

clinical trials
peripheral artery disease
smoking cessation

Abbreviations and Acronyms

PAD
peripheral arterial disease
VAMC
Veterans Administration Medical Center

Cited by (0)

This project was supported by funds from ClearWay Minnesota, Bloomington, Minnesota (Grant No. RC-2005-0039). Dr. Duval has received a research grant from Abbott Vascular. All other authors have reported that they have no relationships to disclose.