Evidence-based practice to assist women in hospital settings to quit smoking and reduce cardiovascular disease risk

J Cardiovasc Nurs. 2008 Sep-Oct;23(5):397-406. doi: 10.1097/01.JCN.0000317449.87649.8e.


Smoking and obesity are widely recognized cardiovascular risk factors for significant morbidity and mortality in women. Although women still smoke less than men do, smoking among women is on the increase, especially in younger women and teenagers. Reduction of cardiovascular risk through smoking cessation while maintaining weight is a major goal of intervention. The purpose of this article is to discuss best care practices for women with tobacco addiction using a 3-point integration of clinical expertise, the best available evidence gained from systematic research, and an analysis of satisfaction with care data. A model for a smoking cessation intervention with weight management content is presented using a conceptual framework of social learning theory, self-efficacy judgments, and the 4 principal sources of self-efficacy information. The specific aims of this pilot study are to (1) test the feasibility of the study methods and procedures, including subject accrual, attrition, and reliability of the instruments and protocol; (2) explore utilization of and satisfaction with the intervention; and (3) describe the impact of the intervention on primary (smoking biomarker) and secondary (weight/body mass index, depression, partner support, and smoking cessation self-efficacy temptations) outcomes. Results show that the study is feasible, but modifications are needed to improve utilization and satisfaction with care. The primary outcome showed a reduction in the smoking biomarker while maintaining weight at the 2-month follow-up. There was also improvement in skills to manage temptation situations that supported the conceptual framework. Hypotheses are presented for a future experimental study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Biomarkers / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Cotinine / metabolism
  • Depression / chemically induced
  • Evidence-Based Medicine / methods*
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Nicotine / administration & dosage
  • Nicotine / adverse effects
  • Nicotinic Agonists / administration & dosage
  • Overweight / chemically induced
  • Patient Satisfaction
  • Pilot Projects
  • Saliva / chemistry
  • Self Efficacy
  • Smoking Cessation / methods*
  • Social Support
  • Substance Withdrawal Syndrome / etiology
  • Treatment Outcome
  • Women's Health


  • Biomarkers
  • Nicotinic Agonists
  • Nicotine
  • Cotinine