IMPACT OF SMOKING ON MEDICATION ADHERENCE AND SECONDARY PREVENTION PRACTICES AMONG PATIENTS WITH CORONARY ARTERY DISEASE IN A TERTIARY CARE HOSPITAL, KARACHI

Abstract

Objective: To assess the impact of smoking on medication adherence and secondary prevention practices among patients diagnosed with coronary artery disease (CAD) at a tertiary care hospital in Karachi.

Methodology: The research was done within Dr. Ruth K.M. Pfau Civil Hospital, Karachi, in six months, between 22^nd November 2024 and 30^th April 2025. It was a prospective and cross-sectional observational study, which involved patients who had a confirmed diagnosis of coronary artery disease (CAD). The structured interviews and medical records review were used to gather information on the smoking status, medication compliance, and the adherence to secondary prevention measures. The demographic factors, clinical risk factors, and biochemical parameters were measured and compared through descriptive statistics. Meanings of the association between smoking and medication adherence were further tested by using inferential statistical analysis to establish the relationship between the two variables.

Results: There were 100 patients who were included. The average age of the study participants was 60.3 years and 12.4 (mean) with 55 percent males and 45 percent females. Out of this group 33 percent were the active smokers, 20 percent were previous smokers and 47 percent were non-smokers. The adherence rates of medications were considerably lower in current smokers than in non-smokers (p < 0.05). More so, poor understanding and low compliance with the secondary prevention recommendations such as diet change, regular exercises, and regular taking of medications demonstrated in 80 percent of smokers.

Conclusion: The results indicate that smoking is closely linked with poor adherence to medication and unfavorable secondary prevention among patients in CAD. Additional treatment use, such as smoking cessation counseling and patient education at a follow-up visit, can lead to better treatment adherence and a reduced cardiovascular outcome.