Smoking Cessation for Patients With Acute Coronary Syndrome (ACS)

Not Applicable

Completed

Interventions: Behavioral: Technique of in-vivo exposure (cigarette) and mental image exposure (craving)
Behavioral: conventional follow-up

Brief Summary: The aim of the present study is to assess if a personal care program of smokers hospitalised for acute coronary syndrome can change the smoking habits as compared with similar patients in conventional care program at 6 months. The program includes a cognitive-behavioural approach associated with a nicotine replacement treatment presented as an obligatory non optional treatment. Patients are men and women of less than 70 years old hospitalised for acute coronary syndrome. Major exclusion criteria is the presence of another dependence. The program includes a cognitive-behavioural approach based on the specific technique of "exposure" and the prescription of nicotine patch considered as other usual cardiologic treatments for at least 6 months. The end point is the smoking habits at 6 months classified as: no smoking confirmed by CO measurement, smoking or doubtful (declaration of no smoking by the patient but a CO level \> 10 ppm). 72 patients in each group will be included in 2 majors sites.

Detailed Description: The cognitive behavioural approach group : This group will receive an inclusion visit at first, then two "cigaret exposures cessions" during hospitalisation. Thereafter-one week after he's out- the patient will come for 5 follow up visits consisting in the specific technique of cigaret exposure and nicotinic treatment adjustment. Then the last visit, at six months, will tell us if the patient is an effective non smoker or not; We'll be also collecting psychological and medical informations (such as the treatment, IMC, cardiovascular check up and psychological tests). The control group : This group is managed as "usual" : the nurse gives very rapid recommendations to the patients concerning smoking cessation. Nicotinic substitutes are proposed to the patients but the patient must find them by itself.

Recruitment & Eligibility

Inclusion Criteria

Patients are men and women of less than 70 years old
Hospitalised for acute coronary syndrome in cardiology Intensive Care Unit
Active smoking >5 cigarettes/day
Has given consent to participate in the study and haven't expressed its opposition the exploitation of data as part of the study

Exclusion Criteria

Presence of another dependence : alcohol abuse avowed or strongly suspected, addiction to drugs, high dose benzodiazepine dependence. clinical assessment
Major psychiatric disorders or history. clinical assessment
Treatment with lithium and neuroleptic. clinical assessment
Patient whose cardiac problem could lead to hemodynamic instability during 48 h after admission.
Patient scheduled for programmed hospitalisation within 6 months after release from hospital (>3 days long, including coronary bypass)
Patients presenting another severe pathology requiring 6 months specific treatments. clinical assessment
Patient which cannot understand or read French
Patient with possible side-effect to nicotine substitute
Patient unaffiliated to any social security regime

Arm && Interventions

Group	Intervention	Description
cognitive behavioural approach	Technique of in-vivo exposure (cigarette) and mental image exposure (craving)	specific technique of cigarette exposure and nicotinic treatment adjustment
usual approach	conventional follow-up	recommendations and nicotinic substitutes

Primary Outcome Measures

Name	Time	Method
The smoking habits at 6 months classified as : no smoking confirmed by CO measurement, smoking or doubtful (declaration of no smoking by the patient but a CO level > 10 ppm).	6 month

Secondary Outcome Measures

Name	Time	Method
Assessment depending of age classes, sex, anxiety scale and other psychological characteristics	6 month

Locations (1): CHU Lariboisière, APHP, Cardiology
🇫🇷
Paris, Ile de France, France

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