Evidence map›Paper›PMID 40312676›Full record

ArticleBMC primary care2025

Investigating the association between recorded smoking cessation interventions and smoking cessation in people living with cardiovascular disease using UK general practice data.

Angela Difeng Wu, Nicola Lindson, Rafael Perera, Min Gao, Paul Aveyard, Rachna Begh, Jamie Hartmann-Boyce

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Angela Difeng WuNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. angela.wu@phc.ox.ac.uk.
Nicola LindsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Min GaoNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rachna BeghNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jamie Hartmann-BoyceDepartment of Health Promotion and Policy, University of Massachusetts, Amherst, MA, USA.

Funding

British Heart Foundation FS/19/78/34716
6 · The paper itself

Abstract

backgroundSmoking significantly increases the risk of cardiovascular diseases (CVD), yet quitting smoking after diagnosis of CVD can mitigate further negative impacts. However, encouraging smoking cessation remains a challenge for General Practitioners (GPs) with concerns regarding mental health. Since 2004, the UK's Quality and Outcomes Framework (QOF) incentivises GP smoking cessation support. Despite this, a significant proportion of individuals diagnosed with CVD continue to smoke after diagnosis. This study aims to investigate the frequencies and types of smoking cessation interventions offered to people with CVD (defined as coronary heart disease (CHD) and stroke), with and without mental illness, and assess their association with successful cessation.

methodsThis retrospective cohort study examined adults diagnosed with CHD or stroke using the QResearch general practice records database (1996-2019). We evaluated the frequency and types of smoking cessation interventions documented in patients' records, including education, brief interventions, pharmacological support, referrals, and counselling. Logistic regression assessed the relationship between recorded interventions and smoking abstinence rates within the one-year post-index event, considering QOF incentives and mental illness presence.

resultsWhile smoking cessation education was common in general practice settings, prescriptions for nicotine replacement therapy or other evidence-based interventions were comparatively low. CHD and stroke populations showed a significant association between any intervention and smoking cessation within one year (CHD: OR 1.41, 95% CI 1.36-1.45; stroke: OR 1.49, 95% CI 1.43-1.55). Education consistently correlated with higher cessation likelihoods, while other interventions were linked to lower rates. Individuals with common and serious mental illness were less likely to quit, irrespective of intervention. QOF implementation led to increased documentation of advice but not intensive support or treatment, with pre-QOF interventions associated with significantly increased abstinence likelihoods (CHD: OR 5.09, 95% CI 4.84-5.35; stroke: OR 4.44, 95% CI 4.07-4.86).

conclusionsFinancial incentives for GP smoking cessation support outlined in QOF may not suffice to enhance methods that are more efficacious or improve cessation rates, especially among people with mental illness. Practical strategies that provide tangible support and treatment are needed for CVD patients, including those with mental illness, to facilitate successful cessation.

Indexed as

Cardiovascular DiseasesGeneral PracticeSmoking CessationAdultAgedCoronary DiseaseFemaleHumansMaleMental DisordersMiddle AgedRetrospective StudiesStrokeUnited Kingdom

Identifiers

PMID40312676
PMCPMC12044739

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.