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Acute Coronary Syndrome as a Teachable Moment for Smoking Cessation

Published online by Cambridge University Press:  16 December 2013

Geoffrey H. Tofler*
Department of Cardiology, Royal North ShoreHospital, University of Sydney, Australia
Robin May
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, Australia
Roger Bartrop
Department of Psychiatry, Royal North Shore Hospital, University of Sydney, Australia
Ann Kirkness
Cardiac Rehabilition, Royal North Shore Hospital, University of Sydney, Australia
Helen Glinatsis
Cardiac Rehabilition, Royal North Shore Hospital, University of Sydney, Australia
Simon de Burgh
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, Australia
Address for correspondence: Geoffrey H. Tofler, Royal North Shore Hospital, St Leonards, NSW 2065. E-mail:


Introduction: Although the teachable moment has been recognised as an important contributor to behaviour change, its role in smoking cessation merits further investigation.

Aim: We prospectively evaluated 116 patients hospitalised with a suspected acute coronary syndrome in two tertiary referral hospitals. The patients comprised 84 men and 32 women, aged 54.2 ± 8.5 years, and the final diagnosis was myocardial infarction in 90 and angina in 26.

Results/Findings: At one month, the self-reported quit rate was 65%, maintained to 61% at 12 months. The quit rate was greater at one and 12 months for those diagnosed with myocardial infarction (70% and 67%) compared with those who had angina (46% and 40%), p<0.05. The strongest motivators for quitting were the heart attack and the consequences of the diagnosis. Of those who quit at 1 month, 77% did so without additional aids.

Conclusions: Hospitalisation with an acute coronary syndrome is associated with a high quit rate, and the diagnosis of heart attack with its potential consequences represents a strong teachable moment to stop smoking. The findings support further investigation of the teachable moment to aid in smoking cessation.

Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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