Smoking cessation in cardiac patients: the influence of action and coping plans and self-efficacy

Introduction
Smoking cessation is the most effective treatment for smokers with coronary heart disease,
yet more than half of cardiac patients continue to smoke. This study examined some factors
that could explain (un)successful smoking cessation in cardiac patients in the postmotivational phase, as postulated by the I-change model (De Vries et al., 2003). In particular,
we examined the influence of making action and coping plans and self-efficacy on intention
to quit and actual smoking cessation.
Method
Cardiac patients from eight hospitals in the Netherlands filled in a baseline questionnaire (N =
245) during their hospital stay, consisting of demographic and smoking characteristics,
intention to quit smoking, smoking behavior, self-efficacy, and making of action plans and
coping plans. The follow up six months later (N = 184) included smoking behavior (continued
abstinence).
Results
Both individual and number of action plans had a direct effect on continued abstinence,
whereas coping plans were unrelated to continued abstinence. Self-efficacy explained 36% of
the variance of intention to quit smoking and was also an indirect predictor of continued
abstinence, through intention. Intention to quit smoking and number of action plans both
directly influenced continued abstinence, explaining 31% of the variance in continued
abstinence.
Conclusions
Future interventions to facilitate smoking cessation in cardiac patients should put more
emphasis on improving self-efficacy. Moreover, making specific action plans could increase
the effectiveness of smoking cessation.