Cardiovascular risk behavior among sedentary female smokers and smoking cessation outcomes

Abstract

Background: We examined female sedentary smokers' additional cardiovascular disease (CVD) risk behaviors and their associations to smoking cessation.

Methods: This study was part of a randomized controlled trial testing the effectiveness of exercise and nicotine gum in smoking cessation. Included in the analyses were 148 participants. Dietary habits and alcohol consumption were measured as additional CVD risk behaviors. High-fat diet and heavy alcohol use were considered those risk behaviors. Nicotine dependence, length of the longest quit attempt, depressive symptoms, self-efficacy, and education were examined as other baseline variables. Abstinence from tobacco was recorded through 12 months.

Results: Diet was related to depressive symptoms at baseline. Alcohol use was related to nicotine dependence and education level. Heavy alcohol use alone and accumulation of two added risk behaviors predicted poorer smoking cessation outcome. Although diet alone was not associated with cessation outcome the high-fat diet interacted with depressive symptoms, such that the depressed women with high-fat diet were significantly more likely to relapse in their quit attempt compared to other subgroups.

Conclusion: Non-moderate alcohol use alone and accumulation of multiple CVD risk behaviors seem to be associated with lower success in smoking cessation.

Figure 1

Experimental design of the trial.

Figure 2

Percent abstinent during 365 days post-cessation by diet. No significant differences were observed.

Figure 3

Percent abstinent during 365 days post-cessation by alcohol consumption. Difference between the curve of moderate drinkers and the one of high consumers was significant (p = 0.02 Log Rank test; p = 0.01 Cox F-test).

Figure 4

Percent abstinent during 365 days post-cessation by accumulation of risk behaviors. The difference between the curve of two risks and the one of no risks was significant (p = 0.001 Cox F-test).

Figure 5a

Percent abstinent during 365 days post-cessation by diet group in depressed participants. Abstinence of those with high depression scores and high-fat diet was significantly poorer than among those depressed with high-vegetable diet (p = 0.02 Log Rank test; p = 0.01 Cox F test).

Figure 5b

Percent abstinent during 365 days post-cessation by diet group in non-depressed participants. Among the participants with low depression scores no significant differences by dietary behavior were observed.