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- cigarette smoking approximately doubles the risk of morbidity and mortality
from ischaemic heart disease compared with a lifetime of not smoking, and the
risk is related to the duration and amount of smoking (1,2)
- all patients with ischaemic heart disease should be advised to stop smoking
because it is a strong risk factor for a first myocardial infarction and for fatal
and non-fatal recurrences
- there is evidence (3) that in patients with
coronary heart disease (CHD), smoking cessation reduces the risk of all cause
mortality and non-fatal myocardial infarction
- the risk of morbidity and mortality associated with cigarette smoking
falls immediately after stopping smoking, although it may be more than 20
years, if at all, before the risk associated with smoking is completely reversed
- smokers are more likely to stop smoking after an acute coronary event - about
20% of patients will give up smoking after an acute myocardial infarction with
a resultant 40% reduction in mortality rates and infarct recurrences (5,6)
for smokers under the age of 50 years the risk of developing coronary heart disease
is 10 times greater than for non-smokers of the same age (7)
smoking also increases the risk of CHD (8)
NC et al.Secondary prevention in coronary heart disease: baseline survey of provision
in general practice. BMJ 1998; 316: 1430-4.
- Cook DG et al. Giving up
smoking and the risk of heart attacks. A report from The British Regional Heart
Study. Lancet 1986; 2: 1376-80.
JA, Capewell S. Mortality risk reduction associated with smoking cessation in
patients with coronary heart disease: a systematic review. JAMA 2003;290:86-97.
- Wald NJ, Watt HC. Prospective study of effect of switching from
cigarettes to pipes or cigars on mortality from three smoking related diseases.
BMJ 1997; 314:1860-3.
- Jolly K et al for the SHIP Collaborative Group.
Randomised controlled trial of follow up care in general practice of patients
with myocardial infarction and angina: final results of the Southamptom heart
integrated care project (SHIP). BMJ 1999; 318: 706-11.
- Wilhelmsen L.
Coronary heart disease: epidemiology of smoking and intervention studies of smoking.
Am Heart J 1988; 115: 242-9.
- British Heart Foundation (Factfile 8/2001).
Stopping smoking - evidence-based guidance.
- JBS2: Joint British Societies'
guidelines on prevention of cardiovascular disease in clinical practice. Heart
2005; 91 (Supp 5).
Last reviewed 01/2018