It is never too late for smokers to quit, but the sooner a patient quits, the better, said Dr. Jules Mesnier of Bichat-Claude Bernard Hospital in Paris.
The doctor conducted a study in which he concluded that quitting smoking is still beneficial even after a smoker is diagnosed with stable coronary heart disease, and it also significantly reduces the risk of serious cardiovascular diseases such as heart attacks.
“Stable coronary heart disease occurs when the coronary arteries are narrowed by calcium deposits,” says Ulrich Laufs, from the Scientific Advisory Board of the German Heart Foundation and director of the Cardiology Unit at Leipzig University Hospital. “Stable” in this context means that there are no life-threatening cardiovascular events caused by blocked blood vessels, such as heart attacks or strokes.
The study, presented at this year’s European Society of Cardiology Congress in London at the end of August, assessed data from 32,378 patients who had been hospitalized for an average of 6.5 years after being diagnosed with coronary heart disease. Of these, about 13,400 (41.3%) had never smoked, about 15,000 (46.2%) were former smokers, and about 4,000 (12.5%) were current smokers.
low risk
In the study, the researchers found that the risk of such serious events was cut by nearly half (44 percent) over a five-year period when patients stopped smoking after diagnosis. In contrast, there was no significant difference in risk between smokers who simply cut back on cigarette consumption and those who maintained the habit.
The first year after diagnosis is especially important, says study author Mesnier. The study showed that among participants who quit smoking after diagnosis, 73 percent started quitting within the first year, significantly reducing their risk of heart attacks and other serious cardiovascular events.
It makes sense that nearly three-quarters of patients who quit smoking after diagnosis start to do so in the first year after diagnosis, says Harm Wenbergen, a cardiologist at the Lenks der Weser Hospital in Bremen. “After such a shocking, life-threatening diagnosis, the motivation to quit smoking is very high,” he says.
Mesnier stresses the need to support patients in facing the challenge of quitting smoking, especially at the time of diagnosis, explaining that telling them that they can “halve their risk of a serious accident or death” is a powerful message of encouragement.
Although former smokers quickly achieved a significant reduction in their risk of heart attacks and other cardiovascular diseases compared with active smokers, they did not reach the low risk of nonsmokers even years after quitting, according to the study.
But for patients who continued to smoke even after diagnosis, their risk of serious events increased by an average of 8 percent per year. “A heart attack can lead to lifelong heart failure and heart valve failure because the entire heart’s function is damaged,” says Finbergen.
Dementia and diabetes
“If you stop smoking — or never smoked — you’re not only doing something good for your heart,” Vinbergen added. Not smoking not only reduces your risk of heart attacks and strokes, but also your risk of dementia and diabetes, among other things.
For smokers — whether they have heart disease or not — to be able to quit, their immediate environment should be smoke-free, Laufs recommended. “The likelihood that someone will be able to quit smoking is related to whether smoking occurs in their immediate area,” he added, explaining that for some patients, medication support or nicotine replacement therapy is also an option.
“I like to tell my patients that it’s never too late to quit smoking,” Mesnier says. “But the sooner you quit, the better for your cardiovascular risk.”