INTRODUCTION Giving up smoking after developing a cardiac disease improves the prognosis more than any other treatment. Hospitalization increases patients’ motivation, however, 57% of those who smoked prior to a cardiac event persist in smoking or relapse soon after hospital discharge. Although there are evidence based smoking cessation interventions available for cardiac patients, they have small effects and do not optimally it the cardiac ward practice. OBJECTIVE This study started in 2009 and examines the (cost)effectiveness and feasibility of two inten- sive smoking cessation counselling methods combined with nicotine replacement therapy (NRT) within the cardiac inpatient setting. The counselling is delivered outside the ward either by telephone (TC) or face-to-face (FC). Interventions are compared against each other and a control group receiving usual care (UC). We expect: - at 6 / 12 months 60% / 55% abstinence in the experimental groups versus 43% / 35% in the control group; - low SES groups -often less motivated to quit- to proit more from FC than high SES groups; - TC to be more cost effective in patients with high quit motivation. METHODS In 8 hospital cardiac wards throughout the Netherlands, 681 cardiac patients who smoked prior to admission aimed to be recruited (227 per group; UC, TC, and FC). A crossover expe- riment with a baseline measurement and post-tests after 6 and 12 months was conducted. Table 1. Outline of the study design INTERVENTIONS In TC and FC: nurses assessed patients’ smoking behaviour, ensured a quit-smoking advice and referred patients to counselling by smoking cessation professionals. TC and FC inclu- ded NRT and behavioural counselling with motivational interviewing, self-control and relapse prevention strategies. Differences: in TC 7 phone calls for 15 minutes; in FC 6 times face to face contact for 45 minutes and a follow-up call 5 weeks after the last consultation. RESULTS 626 patients were included, with signiicant differences in the inclusion rates per group (Figure 1). To date, 408 patients (65%) have completed the 6-months telephone interview and 267 patients (43%) the 12-months interview. The characteristics of the total sample are presented in Table 2. Berndt, N.C. 1,2 , MSc; Lechner, L. 1,2 , PhD; Mudde, M. 1,2 , PhD; de Vries, H. 2,3 , PhD; Bolman, C. 1,2 , PhD CORRESPONDENCE Nadine Berndt, MSc Open University of the Netherlands P.O. Box 2960-NL; 6401 DL Heerlen nadine.berndt@ou.nl 1 Department of Psychology, Open University of the Netherlands, Heerlen, the Netherlands 2 Care School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands 3 Department of Health Promotion, Maastricht University, Maastricht, the Netherlands. Design and progress of a study on (cost)effectiveness of two smoking cessation methods in cardiac patients Ward 1 O1 UC FC TC O2 O3 Ward 5 O1 UC TC FC O2 O3 Ward 2 O1 UC FC TC O2 O3 Ward 6 O1 UC TC FC O2 O3 Ward 3 O1 UC FC TC O2 O3 Ward 7 O1 UC TC FC O2 O3 Ward 4 O1 UC TC FC O2 O3 Ward 8 O1 UC TC FC O2 O3 Note: O1 baseline measurement with questionnaire; O2 6 months post-test by telephone interview; O3 12 months post-test by telephone interview. Variables Gender (male) Age Marital status Married with/without children Single/divorced/widow Education level Low education Intermediate education High education a Disease diagnosis/treatment b ACS AP IAP PCI CABG Other Previous hospital admission (yes) Nicotine dependence (FTND) c Average cigarettes per day 7-days abstinence at admission (PPA) (yes) Quit attempt over the past 12 months (yes) Motivation to quit d n / M 457 57 413 196 244 233 126 370 63 15 77 29 59 122 5.26 21 183 188 2.81 % / SD 73.1 10.77 66.1 31.4 39.0 37.3 20.2 59.2 10.1 2.4 12.3 4.6 9.4 19.5 2.07 12.78 29.3 30.1 0.67 Table 2. Baseline characteristics of the sample (N = 626) Note: Numbers may vary due to missing data. a 0 = primary and basic vocational school, 1 = secondary vocational school and high school degree, 2 = higher vocational school degree, college or university degree ; b ACS = acute coronary syndrome, AP = angina pectoris, IAP = instable angina pectoris, PCI = percutanous coronary intervention, CABG = coronary artery bypass graft; c range from 0 = low nicotine dependence to 10 = high nicotine dependence; d range from 0 = weak motivation to 4 = strong motivation. CONCLUSION The inclusion rate in the FC group is lower than expected, which is related to its time-consu- ming treatment form. There are no signiicant differences between the three groups in terms of the demographical characteristics. However, the motivation to quit is signiicantly higher in the experimental groups compared to the control group. Effectiveness of the interventions at 6 months is currently under investigation. REFERENCES Critchley J, et al. Smoking cessation for the secondary prevention of coronary heart disease. Co- chrane Database Syst Rev. 2004(1):CD003041. Mohiuddin SM, et al. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest. 2007; 131(2):446-452. Barth J, et al. Psychosocial interventions for smoking cessation in patients with coronary heart disease. Cochrane Database Syst Rev. 2008(1):CD006886. Bolman C, et al. Evaluation of a nurse-managed minimal-contact smoking cessation intervention for cardiac inpatients. Health Educ Res. 2002; 17(1):99-116. Lancaster T, et al. Individual counselling for smoking cessation. Cochrane Review; 2005:2. Stead LF, et al. Telephone counselling for smoking cessation. Cochrane Review; 2006:3. 0 50 100 150 200 250 number of patients Control and intervention groups number of patients needed per groep (227) patients included in control group (245) patients included in face-to-face intervention group (157) patients included in telephone intervention group (223) 227 Figure 1. Number of patients included per group (N = 626)