Abstract 3975: A Meta-Analysis of Behavioral Therapy for Smoking Cessation in Cardiac Patients
Introduction: Several meta-analyses have examined the effectiveness of smoking cessation therapies in the general population. However, little is known about the effectiveness of these therapies in cardiac patients. We performed a meta-analysis of randomized controlled trials (RCTs) to determine the effectiveness of behavioral therapy for smoking cessation in cardiac patients.
Methods: We identified 10 behavioral therapy RCTs encompassing 2403 patients (6 post-myocardial infarction (MI); 1 post-bypass surgery; 2 post-MI or bypass surgery; 1 post-MI, bypass surgery, or unstable angina). RCTs differed in the type of behavioral therapy administered, length of therapy administered (20–150 minutes), and total duration of therapy administered (20 minutes-6 months). We only included RCTs with a follow-up of 6–12 months (our measure of smoking cessation favored continuous abstinence over point prevalence and 12 months over 6 months follow-up).
Results: Behavioral therapy was associated with a significantly higher proportion of smoking abstinence in cardiac patients compared with usual care (pooled OR, 2.40; 95% CI, 1.58 to 3.64) (figure⇓). The effectiveness of behavioral therapy was similar to that reported in the one RCT performed in cardiac patients using bupropion (OR, 1.94; 95% CI, 1.39 to 2.72) and in the one using transdermal nicotine (OR, 1.31; 95% CI, 0.80 to 2.14).
Conclusions: Behavioral therapy is effective for smoking cessation in cardiac patients and is similar to pharmacotherapy.