Ask CHD Patients About Secondhand Smoke Exposure

Only 17.3% of non-smoking hospitalized patients with coronary heart disease (CHD) reported that their physician asked them about their secondhand tobacco smoke (SHS) exposure since being admitted to the hospital, according to a recent study¹.

“Hospitalized nonsmokers with coronary heart disease (CHD) should avoid SHS exposure after discharge, but little is known about the frequency of SHS exposure in this population or whether clinicians (including nurses, nurse practitioners, physician's assistants, and physicians) address it,” according to a research letter accompanying the study².
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“The present study assessed self-report and biochemical measures of SHS exposure among hospitalized nonsmokers with CHD and explored patients’ beliefs and the clinicians’ actions about SHS,” they said.

Researchers evaluated 214 patients who were admitted to a hospital with ischemic CHD and did not use tobacco or nicotine replacement. The participants answered questions about their SHS exposure at work, in their care, at home, how they viewed SHS risk, and health care professional interventions regarding SHS exposure since their admission to the hospital.

Researchers found that 22% of patients (47 patients) reported SHS in the 30 days before hospital admission and 33 patients (15.4%) noted SHS in the 7 days prior to admission. Of those participants, approximately 14% lived with a smoker.

They detected cotinine in 8.2% of participants out of 184 participants with sufficient samples: greater or equal to 0.020 ng/mL. Out of 72 saliva samples, 29 participants (40.3%) had detectable cotinine (greater than or equal to 0.05 ng/mL).

Investigators further discovered that 89.7% of patients believed that SHS was harmful to the health of those receiving it secondhand, but only 17.3% of the patients were asked about their SHS exposures since their hospital admission.

The complete letter is published in the November issue of JAMA Internal Medicine.

-Michelle Canales

References:

1. Japuntich SJ, Eilers MA, Shenhav S, et al. Secondhand tobacco smoke exposure among hospitalized nonsmokers with coronary heart disease. JAMA Intern Med. 2014 November [epub ahead of print] doi: 10.1001/jamainternmed.2014.5476.

2. Vandivier RW. Learning to act on secondhand tobacco smoke exposure to limit risk for coronary heart disease. JAMA Intern Med. 2014 November [epub ahead of print] doi: 10.1001/jamainternmed.2014.4046.