Psychosocial interventions such as counseling, telephone support, and self-help material can help patients with heart disease who want to quit smoking, with the most successful treatments lasting a month or longer, according to an article in Issue 1 (2008) Cochrane Database of Systematic Reviews.

The review evaluated evidence from 16 randomized controlled studies of psychosocial quit-smoking interventions for patients with coronary heart disease. Many of the study participants had a history of myocardial infarction or an invasive treatment such as bypass surgery or angioplasty.

"We found support for the efficacy of smoking cessation interventions with more than one-month duration, but brief interventions without some follow-up contact were not effective. We were unable to determine the minimum number of contacts needed," the review authors wrote.

Professor Jurgen Barth, a senior researcher with the Institute of Social and Preventive Medicine at Bern University in Switzerland, led the review.

The review analyzed the effectiveness of different psychosocial quitting aids. The likelihood that a smoker with heart disease would remain abstinent after 6 to 12 months was similar for behavioral counseling, phone support and self-help (information booklets, audio- or videotapes) interventions.

"Most trials used a mixture of different intervention strategies, therefore no single strategy showed superior efficacy," the review found.

Overall, psychosocial smoking cessation interventions for this patient population required about 10 patients to undergo treatment for 1 person to be abstinent from tobacco after one year, the review found.

Professor Saul Shiffman, addictive behavior researcher at the University of Pittsburgh, said many health care providers consider a heart attack a "teachable moment" that can persuade smokers to give up cigarettes.

The review authors noted that after a cardiac event about 30 percent to 50 percent of smokers with coronary heart disease quit smoking without professional help. Psychosocial interventions are able to increase this rate, Barth said.