The Concept of CMR

Smoking Cessation

The only way to decrease a smoker’s CVD risk and eliminate this major CVD risk burden is complete smoking cessation. Each cigarette temporarily increases heart rate and blood pressure, and smoking just a few cigarettes per day has been shown to be harmful to cardiovascular health. Because smoking duration is linked to smoking-related morbidity, early cessation and prevention of relapse are both important objectives.

In the meta-analysis by Shinton et al. (9), ex-smokers under the age of 75 seemed to retain an appreciably increased risk of stroke (1.5), but for all ages, the relative risk in ex-smokers was found to be 1.2. In a systematic review by Critchley et al. (32), quitting smoking was associated with a 36% (relative risk of 0.64) reduction in relative risk of mortality in patients with CHD who quit smoking when compared to those who continued smoking, regardless of age and sex. In Asia, the smoking epidemic’s impact is enormous, and quitting has been shown to provide a clear benefit. In this region, the hazard ratios for ex-smokers was 0.71 for CHD and 0.84 for stroke (17). In the INTERHEART study, the OR associated with smoking fell to 1.87 (current smoking with an OR of 2.95) within 3 years of quitting. However, in people who had quit smoking 20 or more years ago, there was a residual excess risk of AMI of about 22% (18). Even though quitting smoking provides clear overall health benefits, the speed and degree of mortality risk reduction associated with quitting is still being debated in the literature.

Several cessation programs/guidelines are available to smokers and health care professionals. In order to improve smoking cessation rates, effective behavioural and pharmacological treatments, coupled with professional counselling and advice, are required. Since smoking duration is the principal risk factor for smoking-related morbidity, cessation and prevention of relapse are both key goals.

The association between cigarette smoking and CVD is overwhelmingly clear. As a result, clinicians must emphasize to their patients the importance of quitting smoking to reduce their relative CVD risk. Also requiring special attention are the harmful effects of passive smoking and environmental smoke exposure with regard to CHD. Many of the adverse health effects caused by smoking are reversible, and smoking cessation treatments are among the most cost-effective healthcare interventions. Although quitting smoking at a younger age confers the greatest benefit, even those who quit in middle-age can avoid much of the excess healthcare risk associated with smoking.