Is there any gender difference for smoking persistence or relapse following diagnosis or hospitalization for coronary heart disease? Evidence from a systematic review and meta-analysis [accepted manuscript]
Rahman, M. A, Edward, K., Montgomery, L., McEvedy, S. M & Worrall-Carter, L. (2015). Is there any gender difference for smoking persistence or relapse following diagnosis or hospitalization for coronary heart disease? Evidence from a systematic review and meta-analysis [accepted manuscript]. Nicotine and Tobacco Research,18(6), 1399-1407. Retrieved from https://doi.org/10.1093/ntr/ntv222
Introduction: Persistent smoking in patients diagnosed with coronary heart disease (CHD) has a significant effect on morbidity and mortality. Although there has been considerable debate around gender differences in smoking cessation, conclusive evidence on how gender impacts rates of smoking cessation and/or relapse following CHD diagnosis is lacking.
Aims and Methods: Our aim was to test the hypothesis that female smokers with CHD were more likely to persist in smoking or relapse post-diagnosis or hospitalization than male smokers. We searched PubMed and Web of Science databases for studies published in the last 10 years. Meta-analyses were conducted using a random effects model.
Results: Sixteen studies met the inclusion criteria. The aggregated sample size was 36 591, 20 617 (56%) were smokers of which 2564 (12%) were female. Meta-analyses of eight studies where smoking prevalence could be measured, showed that females were less likely to be smokers at baseline than males ( OR = 0.30, 95% CI = 0.13 to 0.70). Overall, one in two (47%) smokers persisted in smoking/relapsed following a diagnosis or hospitalization for CHD; but there was no gender difference in the rate of persistent smoking/relapse ( OR = 1.07, 95% CI = 0.95 to 1.21).
Conclusions: Female smokers with CHD were relatively uncommon in the included study populations. However, the rate of persistent smoking/relapse was high in both female and male smokers following a diagnosis or hospitalization for CHD. Therefore similar, sustained smoking cessation efforts are warranted for both genders.
Implications: There was no gender difference for persistent smoking/relapse following a diagnosis or hospitalization for CHD, but the rate was high in both female and male smokers. Therefore, similar, sustained smoking cessation efforts are warranted for both genders.
Mary MacKillop Institute for Health Research
Open Access Journal Article