Smoking Cessation for Patients With Acute Coronary Syndrome (ACS)

The cognitive behavioural approach group : This group will receive an inclusion visit at first, then two "cigaret exposures cessions" during hospitalisation. Thereafter-one week after he's out- the patient will come for 5 follow up visits consisting in the specific technique of cigaret exposure and nicotinic treatment adjustment. Then the last visit, at six months, will tell us if the patient is an effective non smoker or not; We'll be also collecting psychological and medical informations (such as the treatment, IMC, cardiovascular check up and psychological tests). The control group : This group is managed as "usual" : the nurse gives very rapid recommendations to the patients concerning smoking cessation. Nicotinic substitutes are proposed to the patients but the patient must find them by itself.

• Technique of in-vivo exposure (cigarette) and mental image exposure (craving) (Behavioral), also known as Reduce the urge to smoke, Strategies to avoid the relapse: Nicotine replacement
• conventional follow-up (Behavioral), also known as recommendations: nicotinic substitutes

Primary outcomes

• The smoking habits at 6 months classified as : no smoking confirmed by CO measurement, smoking or doubtful (declaration of no smoking by the patient but a CO level > 10 ppm). [6 month]

Secondary outcomes

• Assessment depending of age classes, sex, anxiety scale and other psychological characteristics [6 month]

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Patients are men and women of less than 70 years old
* Hospitalised for acute coronary syndrome in cardiology Intensive Care Unit
* Active smoking >5 cigarettes/day
* Has given consent to participate in the study and haven't expressed its opposition the exploitation of data as part of the study

Exclusion Criteria:

* Presence of another dependence : alcohol abuse avowed or strongly suspected, addiction to drugs, high dose benzodiazepine dependence. clinical assessment
* Major psychiatric disorders or history. clinical assessment
* Treatment with lithium and neuroleptic. clinical assessment
* Patient whose cardiac problem could lead to hemodynamic instability during 48 h after admission.
* Patient scheduled for programmed hospitalisation within 6 months after release from hospital (>3 days long, including coronary bypass)
* Patients presenting another severe pathology requiring 6 months specific treatments. clinical assessment
* Patient which cannot understand or read French
* Patient with possible side-effect to nicotine substitute
* Patient unaffiliated to any social security regime

• Patrick HENRY, MD,PhD, Principal investigator, Assistance Publique - Hôpitaux de Paris
• Laurent MAGNE, Study director, Cabinet MAGNE & GALLY
• Olivia GALLY, Study director, Cabinet MAGNE & GALLY