High Rates of Sustained Smoking Cessation in Women Hospitalized With Cardiovascular Disease The Women’s Initiative for Nonsmoking (WINS)

Background—Although men hospitalized with cardiovascular disease (CVD) show high smoking-cessation rates, similar
data for women are lacking. We tested the efficacy of smoking-cessation intervention in women hospitalized for CVD.
Methods and Results—In this randomized controlled trial conducted from 1996 to 2001, 277 women diagnosed with CVD
(mean age 61 10 years) were randomly assigned within 1 of 12 San Francisco Bay Area hospitals to a usual-care group
(UG; n 135) or intervention group (IG; n 142). Baseline histories were obtained, and interviews to ascertain
self-reported smoking status occurred at 6, 12, 24, and 30 months after hospitalization. The UG received strong
physician’s advice, a self-help pamphlet, and a list of community resources. The IG received strong physician’s advice
and a nurse-managed cognitive behavioral relapse-prevention intervention at bedside, with telephone contact at intervals
after discharge. The groups were similar demographically and had smoked cigarettes for a median of 38 (IG) or 40 (UG)
years. Time to resumption of continuous smoking was assessed by Kaplan-Meier analysis, and risk differences between
groups were determined. Time smoke-free was significantly greater for the IG than the UG (P 0.038). Point prevalence
for nonsmoking at the interviews was somewhat greater for the IG than the UG (P 0.15 at all times).
Conclusions—Cognitive behavioral intervention resulted in longer average times to resumption of smoking, but in these
2 groups of older women with limited social and financial resources, long-term success rates were similar. Systematic
identification of smokers and even the brief intervention afforded the UG yielded a high smoking-cessation rate over
time.

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