Posted by: Sheila Duffy ASHS | August 4, 2011

Quit and Live

Smoking is one of the major causes of cardiovascular disease, and smokers are almost twice as likely to have a heart attack as people who have never smoked. A recent study from Harvard Medical School suggested that comprehensive stop smoking advice for heart attack patients could save thousands of lives at a relatively low cost.

Yet many smokers are well aware that quitting smoking can be hard to sustain and relapse can be a real problem.  For some, time runs out.  Last week saw reports of research in Italy that tracked over 1200 smokers who were hospitalised for acute coronary syndrome (crushing chest pain that can signal a heart attack) and who had all quit smoking while in hospital. All said they intended to stay smoke-free. However, within a few weeks of their discharge just under a third started smoking again with about the same number relapsing within the first six months. After a year 37% remained smoke-free. Having adjusted for age and other variables, the researchers found that the people who started smoking again were three times more likely to die within a year – five times more likely if they resumed smoking within ten days of leaving hospital.

Previous research in Europe underlines the urgent need for stop smoking advice for patients with heart disease, and suggests that younger and less educated patients may have the most trouble quitting.

Stop smoking support is an effective and a cost-effective medical intervention that can and should be offered to smokers routinely in hospitals. In the Italian research it was noted that the patients had received a few short stop-smoking advice sessions while they were in hospital, but that no further support or treatment was offered after their discharge. With cigarette smoking held to be the single greatest modifiable risk factor for death from ischaemic heart disease and malignancy in the developed world, there are strong arguments both for prioritising smoking cessation for in-patients, and for ensuring a joined up pathway of care and support that supports them to stay quit after they leave hospital. Lives depend on it.

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