Durham, NC—Suffering a myocardial infarction might be expected to compel smokers to change their lifestyles immediately after the event, but new research suggest that isn’t always the case.
A new study in JAMA Cardiology finds that only 7% of older adults who smoked used a prescription smoking-cessation medication within 90 days after being discharged from a hospital following a heart attack.
Duke University researchers and colleagues gathered data from between April 2007 and December 2013 in a large MI registry, examining patient factors associated with early prescription smoking-cessation medication (SCM) use. That was defined as filling a prescription—either bupropion or varenicline—within 90 days postdischarge or supply remaining from a preadmission fill.
Focusing on 9,193 smoking patients with an average age of 70 years who had MI, in this analysis, 97% received smoking-cessation counseling during their hospitalization. Of the very few who filled an early prescription, 47% used bupropion and 53% used varenicline.
The research determined that varenicline use dropped from 12.6% in 2007 to 2.2% in 2013, while bupropion use stayed consistently low—2.5% in 2007 and 3.2% in 2013.
Even when those patients filled scripts for the stop-smoking drugs, they didn’t appear to use them long enough. The median duration of use was 6.2 weeks for bupropion and 4.3 weeks for varenicline, even though the typically recommended course is 12 weeks.
Patients more likely to initiate SCM early tended to be younger; female; living in counties with greater than the median high school graduation rate; having chronic lung disease; and having undergone in-hospital coronary revascularization and/or having peripheral arterial disease.
“Because individuals who successfully quit smoking do so most frequently in the immediate post-MI period, current practices indicate a missed opportunity for smoking cessation and secondary prevention efforts,” they conclude.
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