Background:
Despite well-established advantages of smoking cessation in the prevention and treatment of myocardial infarction (MI) many patients continue smoking after a diagnosis of MI. Recent evidence suggests that higher self-efficacy (SE), or confidence in one's ability to abstain from smoking, is positively associated with successful smoking cessation attempts. This study aimed to investigate the association between SE and smoking cessation outcome at 6 to 12 months after MI in Armenia.

Methods:
Cross-sectional survey was conducted among smoker adult MI patients who were hospitalized at the largest cardiac hospital in Armenia (Nork-Marash Medical Center). Data collection was done at 6 to 12 months after MI through medical chart review and interviewer administered telephone survey. SE at the time of MI was measured through widely used and validated Self-Efficacy Questionnaire (SEQ-12). SEQ-12 consists of two six-item subscales which measure confidence in aptitude to abstain from smoking when facing internal stimuli (e.g. feeling nervous) and external stimuli (e.g. being with a smoker). Logistic regression analysis was performed to reveal the association between SE and quitting outcome.

Results:
About half (54.37%) of 103 surveyed participants quitted smoking after MI. The mean SE score was 33.55 (SD: 16.49) (out of possible 60) which was significantly higher among quitters compared to non-quitters (45.55 vs. 19.26, p< 0.001). Likewise, the difference between was significant in terms of both internal and external subscale scores. Adjusted logistic regression elucidated that each unit increase in SE score was associated with 1.3 times higher odds of quitting (95% CI: 1.17-1.44; p< 0.001).

Conclusions:
The results illustrated that SE is an independent predictor of smoking cessation after MI suggesting that increase in patients' confidence in ability to abstain from smoking will contribute to successful cessation outcomes. This emphasized the importance of behavioral interventions in encouraging and assisting smoking cessation attempts among MI patients.