Intention to abstain from smoking among cardiac rehabilitation patients

the role of attitude, self-efficacy, and craving

Esther C Bakker*, Marjan D Nijkamp, Caroline Sloot, Nadine C Berndt, C.A.W. Bolman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Smoking cessation after developing coronary heart disease improves disease prognosis more than any other treatment. However, many cardiac patients continue to smoke after hospital discharge.

OBJECTIVE: The aim of this study was to investigate factors associated with the intention to (permanently) abstain from smoking among cardiac rehabilitation patients 2 to 4 weeks after discharge from hospital.

METHODS: A cross-sectional survey was conducted among 149 cardiac rehabilitation patients recruited from 2 cardiac rehabilitation centers in The Netherlands 2 to 4 weeks after hospital discharge, at the start of the cardiac rehabilitation period. Psychosocial cognitions including attitude toward nonsmoking, social influence, and self-efficacy were measured with a standardized and validated Dutch questionnaire based on the Attitude-Social Influence-Self-efficacy model. Anxiety was measured using the shortened version of the State-Trait Anxiety Inventory. Craving for cigarettes was assessed with 6 items measuring the urge to smoke. Intention toward nonsmoking was assessed with 2 visual analog scales indicating the strength and probability of the intention to permanently refrain from smoking.

RESULTS: Of all patients, 31% still smoked after hospital discharge. The smokers had a lower self-efficacy and intention to abstain from smoking and reported higher craving. Logistic regression analyses revealed that attitudes that embraced the advantages of not smoking, self-efficacy, and craving were significantly related to the intention to (permanently) abstain from smoking, whereas social influence and anxiety were not. Actual smoking behavior moderated the relation between self-efficacy and intention: only the quitters showed a significant positive relation. Anxiety did not moderate the relationship between psychosocial cognitive factors and intention.

CONCLUSIONS: The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors.

Original languageEnglish
Pages (from-to)172-179
Number of pages8
JournalJournal of Cardiovascular Nursing
Volume30
Issue number2
DOIs
Publication statusPublished - 1 Mar 2015

Fingerprint

Self Efficacy
Smoking
Anxiety
Smoking Cessation
Smoke
Rehabilitation Centers
Cardiac Rehabilitation
Craving
Visual Analog Scale
Tobacco Products
Netherlands
Cognition
Coronary Disease
Hospitalization
Cross-Sectional Studies
Logistic Models
Regression Analysis
Psychology
Equipment and Supplies

Keywords

  • Aged
  • Attitude to Health
  • Female
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction/psychology
  • Netherlands
  • Patient Acceptance of Health Care/statistics & numerical data
  • Risk Factors
  • Self Efficacy
  • Smoking/psychology
  • Smoking Cessation/psychology

Cite this

@article{ddb45f91399b4f3e9a30a4516b3b2872,
title = "Intention to abstain from smoking among cardiac rehabilitation patients: the role of attitude, self-efficacy, and craving",
abstract = "BACKGROUND: Smoking cessation after developing coronary heart disease improves disease prognosis more than any other treatment. However, many cardiac patients continue to smoke after hospital discharge.OBJECTIVE: The aim of this study was to investigate factors associated with the intention to (permanently) abstain from smoking among cardiac rehabilitation patients 2 to 4 weeks after discharge from hospital.METHODS: A cross-sectional survey was conducted among 149 cardiac rehabilitation patients recruited from 2 cardiac rehabilitation centers in The Netherlands 2 to 4 weeks after hospital discharge, at the start of the cardiac rehabilitation period. Psychosocial cognitions including attitude toward nonsmoking, social influence, and self-efficacy were measured with a standardized and validated Dutch questionnaire based on the Attitude-Social Influence-Self-efficacy model. Anxiety was measured using the shortened version of the State-Trait Anxiety Inventory. Craving for cigarettes was assessed with 6 items measuring the urge to smoke. Intention toward nonsmoking was assessed with 2 visual analog scales indicating the strength and probability of the intention to permanently refrain from smoking.RESULTS: Of all patients, 31{\%} still smoked after hospital discharge. The smokers had a lower self-efficacy and intention to abstain from smoking and reported higher craving. Logistic regression analyses revealed that attitudes that embraced the advantages of not smoking, self-efficacy, and craving were significantly related to the intention to (permanently) abstain from smoking, whereas social influence and anxiety were not. Actual smoking behavior moderated the relation between self-efficacy and intention: only the quitters showed a significant positive relation. Anxiety did not moderate the relationship between psychosocial cognitive factors and intention.CONCLUSIONS: The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors.",
keywords = "Aged, Attitude to Health, Female, Health Behavior, Humans, Male, Middle Aged, Myocardial Infarction/psychology, Netherlands, Patient Acceptance of Health Care/statistics & numerical data, Risk Factors, Self Efficacy, Smoking/psychology, Smoking Cessation/psychology",
author = "Bakker, {Esther C} and Nijkamp, {Marjan D} and Caroline Sloot and Berndt, {Nadine C} and C.A.W. Bolman",
year = "2015",
month = "3",
day = "1",
doi = "10.1097/JCN.0000000000000156",
language = "English",
volume = "30",
pages = "172--179",
journal = "Journal of Cardiovascular Nursing",
issn = "0889-4655",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "2",

}

Intention to abstain from smoking among cardiac rehabilitation patients : the role of attitude, self-efficacy, and craving. / Bakker, Esther C; Nijkamp, Marjan D; Sloot, Caroline; Berndt, Nadine C; Bolman, C.A.W.

In: Journal of Cardiovascular Nursing, Vol. 30, No. 2, 01.03.2015, p. 172-179.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Intention to abstain from smoking among cardiac rehabilitation patients

T2 - the role of attitude, self-efficacy, and craving

AU - Bakker, Esther C

AU - Nijkamp, Marjan D

AU - Sloot, Caroline

AU - Berndt, Nadine C

AU - Bolman, C.A.W.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - BACKGROUND: Smoking cessation after developing coronary heart disease improves disease prognosis more than any other treatment. However, many cardiac patients continue to smoke after hospital discharge.OBJECTIVE: The aim of this study was to investigate factors associated with the intention to (permanently) abstain from smoking among cardiac rehabilitation patients 2 to 4 weeks after discharge from hospital.METHODS: A cross-sectional survey was conducted among 149 cardiac rehabilitation patients recruited from 2 cardiac rehabilitation centers in The Netherlands 2 to 4 weeks after hospital discharge, at the start of the cardiac rehabilitation period. Psychosocial cognitions including attitude toward nonsmoking, social influence, and self-efficacy were measured with a standardized and validated Dutch questionnaire based on the Attitude-Social Influence-Self-efficacy model. Anxiety was measured using the shortened version of the State-Trait Anxiety Inventory. Craving for cigarettes was assessed with 6 items measuring the urge to smoke. Intention toward nonsmoking was assessed with 2 visual analog scales indicating the strength and probability of the intention to permanently refrain from smoking.RESULTS: Of all patients, 31% still smoked after hospital discharge. The smokers had a lower self-efficacy and intention to abstain from smoking and reported higher craving. Logistic regression analyses revealed that attitudes that embraced the advantages of not smoking, self-efficacy, and craving were significantly related to the intention to (permanently) abstain from smoking, whereas social influence and anxiety were not. Actual smoking behavior moderated the relation between self-efficacy and intention: only the quitters showed a significant positive relation. Anxiety did not moderate the relationship between psychosocial cognitive factors and intention.CONCLUSIONS: The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors.

AB - BACKGROUND: Smoking cessation after developing coronary heart disease improves disease prognosis more than any other treatment. However, many cardiac patients continue to smoke after hospital discharge.OBJECTIVE: The aim of this study was to investigate factors associated with the intention to (permanently) abstain from smoking among cardiac rehabilitation patients 2 to 4 weeks after discharge from hospital.METHODS: A cross-sectional survey was conducted among 149 cardiac rehabilitation patients recruited from 2 cardiac rehabilitation centers in The Netherlands 2 to 4 weeks after hospital discharge, at the start of the cardiac rehabilitation period. Psychosocial cognitions including attitude toward nonsmoking, social influence, and self-efficacy were measured with a standardized and validated Dutch questionnaire based on the Attitude-Social Influence-Self-efficacy model. Anxiety was measured using the shortened version of the State-Trait Anxiety Inventory. Craving for cigarettes was assessed with 6 items measuring the urge to smoke. Intention toward nonsmoking was assessed with 2 visual analog scales indicating the strength and probability of the intention to permanently refrain from smoking.RESULTS: Of all patients, 31% still smoked after hospital discharge. The smokers had a lower self-efficacy and intention to abstain from smoking and reported higher craving. Logistic regression analyses revealed that attitudes that embraced the advantages of not smoking, self-efficacy, and craving were significantly related to the intention to (permanently) abstain from smoking, whereas social influence and anxiety were not. Actual smoking behavior moderated the relation between self-efficacy and intention: only the quitters showed a significant positive relation. Anxiety did not moderate the relationship between psychosocial cognitive factors and intention.CONCLUSIONS: The intention to (permanently) abstain from smoking, measured 2 to 4 weeks after hospitalization for a cardiac event, predominantly depends on attitude, self-efficacy, and craving. Interventions aimed at smoking cessation among cardiac rehabilitation patients should focus on these factors.

KW - Aged

KW - Attitude to Health

KW - Female

KW - Health Behavior

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/psychology

KW - Netherlands

KW - Patient Acceptance of Health Care/statistics & numerical data

KW - Risk Factors

KW - Self Efficacy

KW - Smoking/psychology

KW - Smoking Cessation/psychology

U2 - 10.1097/JCN.0000000000000156

DO - 10.1097/JCN.0000000000000156

M3 - Article

VL - 30

SP - 172

EP - 179

JO - Journal of Cardiovascular Nursing

JF - Journal of Cardiovascular Nursing

SN - 0889-4655

IS - 2

ER -