Impact of first cardiovascular event versus consecutive episodes on tobacco and alcohol use: a comprehensive analysis

BACKGROUND
Consumption of tobacco and alcohol is among the main causes of cardiovascular diseases (CVD). It has been reported that awareness of disease may help with tobacco or alcohol cessation. We aim to determine how the diagnosis of a CVD event affects the smoking and drinking habits of cardiology inpatients.
METHODS
250 patients were recruited from the cardiology ward in a high-complexity community hospital in Barcelona from May 2021 to February 2023. Patients were categorized into two groups: those who experienced a first cardiovascular event and those admitted consecutively.
We explored their tobacco and alcohol use patterns using the Timeline Followback questionnaire and the ASSIST scale at the time of recruitment and during a follow-up telephone interview after one year. We collected information on sociodemographic and potential confounders. A generalized linear model, with time and group conditions as the primary factors, was employed to assess potential main effects between groups and time, as well as to examine their interaction with use patterns.
RESULTS
Patients admitted during their first CVD event exhibited a higher prevalence of tobacco and alcohol use compared to those admitted consecutively. However, at follow-up, no significant differences were observed in the prevalence between groups. Patients hospitalized due to a first cardiovascular event demonstrated a significant reduction in their nicotine use after one year. In contrast, there were no significant differences in alcohol use prevalence. In the group of those consecutively admitted no reductions in use were found after one year. 
DISCUSSION AND CONCLUSIONS
Our study reveals that patients hospitalized for a first cardiovascular event experienced a notable reduction in nicotine use over the follow-up period, a change not observed in consecutively admitted patients. A significant interaction effect between time and group was found for nicotine use. There were no changes in alcohol prevalence of use over time for both groups.
While interventions by cardiologists demonstrated effectiveness for patients experiencing their first cardiovascular event, those with multiple episodes may benefit from additional support. Furthermore, our findings underscore the significance of systematically assessing and addressing tobacco and alcohol use during hospitalization for cardiovascular events. Importantly, comprehensive strategies to tackle alcohol use should be implemented upon admission, involving multidisciplinary teams.