• Diann E Gaalema, Irene Pericot-Valverde, Janice Y Bunn, Andrea C Villanti, Antonio Cepeda-Benito, Nathan J Doogan, Diana R Keith, Allison N Kurti, Alexa A Lopez, Tyler Nighbor, Maria A Parker, Amanda J Quisenberry, Ryan Redner, Megan E Roberts, Cassandra A Stanton, Philip A Ades, and Stephen T Higgins.
• Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychiatry, University of Vermont, Burlington, VT, USA; Psychological Science, University of Vermont, Burlington, VT, USA. Electronic address: dgaalema@uvm.edu.
• Prev Med. 2018 Dec 1; 117: 76-82.

AbstractSmoking status following cardiac events strongly predicts future morbidity and mortality. Using a nationally representative sample of United States adults, aims of this study were (1) to estimate use of, and attitudes towards, tobacco products as a function of level of cardiac risk, and (2) to explore changes in attitudes and tobacco use among adults experiencing a recent myocardial infarction (MI). Data were obtained from the first and second waves of the Population Assessment of Tobacco and Health (PATH) study. Use and attitudes towards tobacco products were examined at Wave 1 among adults with no chronic health condition (n = 18,026), those with risk factors for heart disease (n = 4593), and those who reported ever having had an MI (n = 643). Changes in perceived risk of tobacco and use between the two waves and having an MI in the last 12 months (n = 240) were also examined. Those who reported lifetime MI were more likely to believe that smoking/using tobacco was causing/worsening a health problem. Having had a recent MI event increased perceived tobacco-related risk and attempts at reduction/quitting, but did not significantly impact combusted tobacco cessation/reduction or uptake of non-combusted tobacco products. Sociodemographic characteristics and use of other tobacco products were associated with change in use of tobacco products. Those who have an MI are sensitized to the harm of continued smoking. Nonetheless, having an MI does not predict quitting combusted tobacco use or switching to potentially reduced harm products. Intense intervention is necessary to reduce combusted use in this high-risk population.Copyright © 2018 Elsevier Inc. All rights reserved.

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