Therapy, support help heart patients quit smoking

NEW YORK (Reuters Health) - Counseling and self-help programs can help people with heart disease quit smoking, according to a review of published studies.

But these interventions must last longer than a month to be effective, Dr. Jurgen Barth of the University of Bern in Switzerland and colleagues conclude.

Smokers who don't kick the habit after being diagnosed with heart disease are more likely to suffer a repeat blood vessel blockage, and also face an increased risk of death from the disease, the researchers note in a review published by The Cochrane Collaboration, an international non-profit group that funds systematic reviews of health care interventions.

Barth and colleagues sought to gauge the effectiveness of behavioral therapy, telephone support and self-help programs -- known collectively as psychosocial interventions -- for helping smokers with heart disease kick the habit. They reviewed 16 randomized controlled trials in which the interventions were compared to a placebo.

Therapy, phone support and self-help were similarly effective in helping people to quit, increasing the odds of kicking the habit by 69 percent, 58 percent and 48 percent, respectively, the researchers found.

There was no "clear evidence" that any one strategy was more effective than another, they say, but it was difficult to separate out the three therapy types' effectiveness because some studies looked at combinations of interventions.

Studies in which objective tests were used to determine if patients had actually quit, for example by checking levels of the nicotine-related chemical cotinine in saliva, found that the interventions were less effective than studies that relied on patients' own reports.

More intense interventions were more effective, the researchers found, but those that lasted for less than four weeks were not helpful.

Future research should look at whether combining psychosocial approaches with nicotine replacement therapy will provide added benefits, and should also use objective measures to validate whether trial participants actually have quit, they conclude.

SOURCE: The Cochrane Library 2008.