After a heart attack, many continue to smoke
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Fewer than half of cigarette smokers quit after experiencing a first cardiac event, according to a survey of Europeans. One in five continue to light up despite personal advice from their doctor to stop smoking, the survey shows.
It is “unbelievable” that so many people continue to smoke after a life-threatening event for which smoking is a major risk factor, Dr. Wilma Scholte op Reimer said in a statement. She wonders whether they are “truly aware of the risk that they are taking.”
Clearly, there is still a need to develop effective smoking cessation programs, she and colleagues note in the latest issue of the European Heart Journal.
For the survey, researchers interviewed 5,551 heart patients in 47 hospitals in 15 European countries more than one year after the event or condition that landed them in the hospital, namely heart bypass surgery, balloon angioplasty (for clogged arteries), a heart attack, or a type of worsening chest pain called unstable angina.
The interviewers asked participants whether they had smoked in the 30 days prior to being admitted to the hospital and whether they currently smoked.
Those who denied smoking took a breath test for carbon monoxide, just to be sure. Scholte op Reimer, from Erasmus Medical Center in Rotterdam, and colleagues report that nearly one quarter (21 percent) of the 5,551 survey subjects were still smoking after the cardiac event.
Virtually all (99 percent) of the 2,244 individuals who smoked before the heart event had been advised by their doctor to stop, but only 48 percent actually stopped.
Smokers younger than age 50 were less likely to quit than older smokers. Those with angina (chest pain) were also less likely to give up smoking than were those who had suffered a heart attack.
This latter finding is worrisome, Scholte op Reimer said, because it hints that chest pain patients may not be aware that they are at heightened risk of suffering a heart attack. In reality, the long-term risk of death in chest pain patients is comparable to that of heart attack patients.
“Perhaps this needs to be spelled out” more clearly to chest pain patients, Scholte op Reimer said.
“The need to stop (smoking) is highest in patients with established coronary heart disease (CHD) as within 2-3 years the risk of subsequent events falls to that of CHD patients who have never smoked,” she explained. “In people with no symptoms it takes up to 10 years for risks to fall to the level of non-smokers. This shows how much a patient can gain from quitting—often much more than most of the medication they take.”
SOURCE: European Heart Journal, online October 6, 2005.
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