Smoking Behavior Among Patients With Coronary Artery Diseases

Coronary Heart Diseases CHD are a global health problem which strikes millions of people worldwide and causing life time severs disability. Objective : to determine the impact of smoking behavior on patients with Coronary Artery Diseases. Method : A descriptive quantitative study is carried out at al sadder medical city from Feb.23, 2012 to April 15,2012 A simple randomized sample of 60 coronary Artery diseases patients who were admitted to the Al-sadder medical city. The data were collected through the use of semi-constructed questionnaire which consists of two parts; the first part consist (age, gender, educational level, marital status, diagnosis, duration of illness) and second part consist of (smoking behavior of the patients before and after CAD, kind of smoking, number cigarettes smoking, and period of smoking before and after CAD occurrence, source of smoking, reason discourage from quitting smoking, and the source of advice to stop smoking). After gathering the data, the information was statistically analyzed through the application of percentage and frequency by using ( SPSS) version 16.0. Results : about (46.7%) of the patients were diagnosed with Angina. About (76.7%) of the patients have duration of illness from (1-10) years. (66.7%) of the patients were current smokers before CAD. And (38.3%) of patients were still persistent in smoking after CAD occurrence. (85%) of the patients were smoking cigarettes only and about (15%) smoke cigarettes and waterpipe. And (40%) of the patients the source in smoking behavior was the friends. Conclusion : The study concluded that Coronary Artery Disease occurs in people with smoking behavior. Moreover, smoking behavior affected negatively on patients with coronary heart disease. Recommendations: the enactment from the Parliament to ban smoking in public places and to implement systematic smoking cessation programs to promote CAD patients' motivation to quit smoking , and great a preventive center to improve community awareness about the harms of smoking.


Statistical Analysis:
The data of the present study were analyzed through the use of statistical Frequencies and Percentage.

Table (1): Characteristic of the patients included in the study
Table (1) shows that the highest percentage among age groups were (28.3%) for each age groups (41-50) and (61-75).And the highest percentage were male (83.3%) and the remaining were female.Regarding the educational level, illiterate represented the highest percentage (36.7%)among all others.Concerning Marital status, the highest percentage (85%) were married.(3) indicates that the majority of patients (76.7%) had (1-10) years duration of illness.And the lowest percentage (6.7%) in those with more than 10 years of illness.4) shows that (66.7%) of the patients were smoker before the disease started.And (38.3%) of the patients continue smoking after they become diseased with CAD, and only (28.4%) of the patients quit smoking.6) shows that most of the patients under study (85%) had a period of smoking (1-20) years before they affected with CAD.

Table (7):
The number cigarettes per day before and after CAD Table (7) indicated that (85%) of the patients smoke (1-39 cigarettes) and only (15%) smoke more than 39 cigarettes daily before CAD.The result shows that (65%) of patients smoke (1-39) cigarettes daily after they become diseased with CAD.

Table (9): The source of smoking habit and the reason to stop and reason of smoking
Table (9) shows that (41.7%) of the patients pickup the smoking habit from different sources and about (40%) of the patients their source for smoking was the friends.And (91.7%) of the patients get advice to stop smoking from more than one source while (36.7%) of the patients show that there reason for smoking was Social acceptance.

DISCUSSION:
Results show that a person's risk of heart attack greatly increases with the number of cigarettes he or she smokes.There is no safe amount of smoking.(Lemone and Burke, 2008) mentioned that people who smoke a number of cigarettes a day have more than twice the risk of heart attack than nonsmokers.The more cigarettes smoking, the greater the risk of developing coronary heart diseases.The results showed that no matter how long a person been smoker or how much he smoke, quitting of smoking will reduce the chances of developing heart disease.Quitting smoking has definite health benefits.Ceasing smoking is helpful for those suffering from coronary heart disease.(Parker, 2012).The result shows that (38.3%) of the patients persisted on smoking after they been diagnosed.The result was in agreement with the study of Achari and Thakur, (2004) who indicated in their study that the majority of the CHD patients continue to smoke after their disease occurrence.In a study of Abu-Baker, et al. (2010) to compare the frequency of cigarette smoking before and after diagnosis of CAD, showed that after disease occurrence only (29.7%) of the patients quit smoking, while (60.7%) continued smoking, and (9.6%) relapsed.In addition, the study shows that one out of each five patients smoked, despite a personal advice to stop.Thus, still there is a need for the development of effective smoking cessation programs (Scholte, et al 2006).For both males and females who stopped smoking, the risk of mortality from CHD is reduced by half.Nicotine also constricts arterial limiting tissue perfusion (blood flow and oxygen delivery) further nicotine reduces HDL level and increase platelet aggregation, increase the risk of thrombus.(Lemone and burke, 2008).Patients with an increased risk for heart disease is encourage to stop tobacco consumption through any mean possible, education programs, counseling,

Table ( 5
) reveals that most of patients smoke cigarettes 85%, and the remaining (15%) smoke both cigarettes and waterpipe.

Table ( 8
) indicates that there was no difference in the percentage of the patients who use waterpipe before and after the patients become diseased with coronary artery disease.