TY - JOUR
T1 - Tobacco Cessation Among Acute Coronary Syndrome Patients in Kerala, India
T2 - Patient and Provider Perspectives
AU - Bhaumik, Smitha S.
AU - Placek, Caitlyn
AU - Kochumoni, R.
AU - Lekha, T. R.
AU - Prabhakaran, Dorairaj
AU - Hitsman, Brian
AU - Huffman, Mark D.
AU - Harikrishnan, Sivadasanpillai
AU - Goenka, Shifalika
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Vanderbilt-Emory-Cornell-Duke Fogarty Global Health Fellowship [NIH/ Fogarty 5R25TW009337-06]. The data collection for the Acute Coronary Syndrome Quality Improvement in Kerala trial upon which this was based was funded by the National Institutes of Health/National Heart Lung and Blood Institute [R00HL107749], Cardiological Society of India—Kerala chapter, Center for Chronic Disease Control, the Northwestern Global Health Initiative, and the Northwestern University Clinical and Translation Science Institute [UL1TR001422].
Funding Information:
We thank the doctors, nurses and patients at Sree Chitra Tirunal Institute for Medical Sciences and Technology who graciously agreed to participate in this study and for the support of the institution?s staff and administration. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Vanderbilt-Emory-Cornell-Duke Fogarty Global Health Fellowship [NIH/Fogarty 5R25TW009337-06]. The data collection for the Acute Coronary Syndrome Quality Improvement in Kerala trial upon which this was based was funded by the National Institutes of Health/National Heart Lung and Blood Institute [R00HL107749], Cardiological Society of India?Kerala chapter, Center for Chronic Disease Control, the Northwestern Global Health Initiative, and the Northwestern University Clinical and Translation Science Institute [UL1TR001422].
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Tobacco cessation is an important intervention to reduce mortality from ischemic heart disease, the leading cause of death in India. In this study, we explored facilitators, barriers, and cultural context to tobacco cessation among acute coronary syndrome (ACS, or heart attack) patients and providers in a tertiary care institution in the south Indian state of Kerala, with a focus on patient trajectories. Patients who quit tobacco after ACS expressed greater understanding about the link between tobacco and ACS, exerted more willpower at the time of discharge, and held less fatalistic beliefs about their health compared to those who continued tobacco use. The former were motivated by the fear of recurrent ACS, strong advice to quit from providers, and determination to survive and financially provide for their families. Systemic barriers included inadequate training, infrequent prescription of cessation pharmacotherapy, lack of ancillary staff to deliver counseling, and stigma against mental health services.
AB - Tobacco cessation is an important intervention to reduce mortality from ischemic heart disease, the leading cause of death in India. In this study, we explored facilitators, barriers, and cultural context to tobacco cessation among acute coronary syndrome (ACS, or heart attack) patients and providers in a tertiary care institution in the south Indian state of Kerala, with a focus on patient trajectories. Patients who quit tobacco after ACS expressed greater understanding about the link between tobacco and ACS, exerted more willpower at the time of discharge, and held less fatalistic beliefs about their health compared to those who continued tobacco use. The former were motivated by the fear of recurrent ACS, strong advice to quit from providers, and determination to survive and financially provide for their families. Systemic barriers included inadequate training, infrequent prescription of cessation pharmacotherapy, lack of ancillary staff to deliver counseling, and stigma against mental health services.
KW - India
KW - South Asia
KW - cardiac events
KW - framework analysis
KW - heart attacks
KW - qualitative
KW - qualitative research
KW - quitting
KW - smoking
KW - tobacco cessation
UR - http://www.scopus.com/inward/record.url?scp=85059684891&partnerID=8YFLogxK
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U2 - 10.1177/1049732318817047
DO - 10.1177/1049732318817047
M3 - Article
C2 - 30547727
AN - SCOPUS:85059684891
SN - 1049-7323
VL - 29
SP - 1145
EP - 1160
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 8
ER -
