Smoking Cessation Rates and Barriers Among Cardiac Patients Following a Cardiac Rehabilitation Programme at a Heart Centre in Malaysia

Chau Chung, Chai and Sing Kock, Bong and Be Kim, Leong and Lin Kiat, Liew and Joanna Varuges, Abraham and Sriganes, Nachimuthu (2025) Smoking Cessation Rates and Barriers Among Cardiac Patients Following a Cardiac Rehabilitation Programme at a Heart Centre in Malaysia. Journal of the Hong Kong College of Cardiology, 32 (4). p. 27. ISSN 2790-6744

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Abstract

Objectives: Smoking cessation is crucial for improving cardiovascular health outcomes in a cardiac rehabilitation programme (CRP). Despite its importance, local studies on smoking cessation rates and barriers among cardiac patients following CRP in Malaysia are limited. This study aimed to evaluate smoking cessation rates and identify barriers to smoking cessation among cardiac patients following CRP at Sarawak Heart Centre, Malaysia. Methods: We conducted a retrospective study from August 2021 to July 2022, analysing the medical records of 120 cardiac patients who completed CRP at Sarawak Heart Centre, Malaysia. Smoking status was recorded at three time points: upon enrolment in CRP, upon CRP completion, and one year post-CRP. Smoking cessation rates were calculated by measuring the percentage reduction in active smokers from baseline (upon CRP enrolment) to CRP completion and one year post-CRP. To identify barriers to smoking cessation, reasons for failure to quit smoking were obtained from active smokers at one year post-CRP. Results: Demographic data showed that 95.8% (n=115) of the patients were male, and 4.2% (n=5) were female. The mean age of the patients was 56.1 years (SD = 10.3 years). Ethnic distribution included 40.8% (n=49) Malay, 33.3% (n=40) Chinese, 25% (n=30) Indigenous Sarawak, and 0.8% (n=1) Indian. Diagnoses included acute coronary syndrome (85%, n=102), stable angina (10.8%, n=13), and heart failure (4.2%, n=5). At CRP enrolment (baseline), 17.5% (n=21) of patients were active smokers. Upon CRP completion, the smoking cessation rate was 23.8%, with 13.3% (n=16) of patients remaining active smokers. One year post-CRP, the cessation rate improved to 52.4%, with only 8.3% (n=10) of patients remaining active smokers. Barriers to smoking cessation included peer pressure in the working environment (30%, n=3), lack of self-control (30%, n=3), lack of motivation (20%, n=2), and unsuccessful nicotine replacement therapy (20%, n=2). Conclusion: This study demonstrated an increase in smoking cessation rates from approximately one-quarter upon CRP completion to over half at one year post-CRP. The identified barriers highlight the need for targeted interventions to further improve smoking cessation outcomes.

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