Data for men and women have generally been pooled and sample sizes for women have been too small to draw conclusions, according to Froelicher. However, evidence from other studies has helped WINS researchers tailor the intervention for women. Fear of weight gain is one of the most frequent excuses women use for not quitting, and weight gain is a key relapse trigger, said Froelicher. Study participants are briefed about maintaining a diet low in fat and cholesterol and given lists of low fat snacks and sweets that can assist them through their early efforts. These lists, and other important smoking cessation information, are taken from the American Heart Association's Active Partnership for the Health of Your Heart workbook.
Exercise is encouraged as an aid in coping with stress.
Study participants are also referred to the stress management section of the workbook and the relaxation audiotape. Women are encouraged to listen to the 15-minute tape daily for the first month after hospital discharge and then as needed. Because women have heart attacks at a later age, they are more likely to be widowed, single, or living alone. Therefore, special emphasis is placed on social support provided by the nurse in the hospital and in follow-up telephone calls, said Froelicher. The menstrual cycle may also complicate smoking cessation.