A study on the factors affecting smoking behavior during hospitalization among patients with cardiovascular disease (CVD) in mainland China

Abstract

BACKGROUND: China has the largest population of smokers in the world. Hospitalization in a smoke-free hospital is considered to be a unique opportunity for patients with a smoking-related illness, such as CVD, to quit smoking. This study aims to explore the factors affecting patients’ smoking behaviour during hospitalization in a smoke-free hospital in Mainland China. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted in 4 medical wards and 5 surgical wards of a CVD hospital in Beijing, China from September to November 2008. All hospitalized CVD patients who (1) smoked at least one cigarette within the 30 days prior to their admission; (2) hospitalized in cardiology medical or surgical wards; (3) had stayed in the hospital for at least 48 hours, and were to be discharged within 24 hours; (4) were 18 years of age or older; were invited to participate in the study. RESULTS: A total of 325 patients completed the questionnaire, with 26.2% (95%CI: 21.35%30.96%) reported to continue smoking during their hospital stay. Univariable regression analysis showed the following factors significantly associated with smoking during hospitalization: (1) before admission: higher daily cigarettes consumption and higher nicotine dependence; (2) during hospitalization: shorter length of hospital stay and unawareness of the smoke-free hospital policy; (3) psychological factors: lower motivation in succeeding in future attempts, perceived more difficulties in quitting smoking, lower confidence in their abilities to quit smoking and lower self-efficacy in resisting smoking. In the multivariable regression model, smoking during hospitalization was associated with the shorter length of hospital stay and lower confidence in their abilities to quit smoking. CONCLUSIONS: This is the first study to examine the smoking behaviour and factors affecting such behaviour during hospitalization among CVD patients in a smoke-free hospital in Mainland China. Some smokers still continue to smoke in spite of staying in a smoke-free hospital, and hospitalization is a teachable moment for providing smoking cessation interventions.