If you ever needed a swift smack upside the head to convince you to finally stop smoking once and for all, you’d think that a heart attack would do it.
Hospitalized survivors, shocked and traumatized, are already lying there in the cardiac ward unable to light up, and certainly prohibited from smoking anywhere inside the hospital buildings. In some regions, smoking is even banned on hospital grounds, thus requiring a long walk clear across the street, if the patient is even mobile, with the attractive hospital gown flapping in the wind behind. These smokers are already well underway, whether they’d planned it or not, to quitting cold turkey. So why are they starting up again by the time they get home?
Are there any smokers alive out there who are not already aware that smoking is likely what landed them in that cardiac ward in the first place? Just in case there are, here’s why smoking is so damaging to the heart:
- it speeds up progression of atherosclerosis (plaque formation)
- it alters cholesterol – more LDL (bad) cholesterol and less HDL (good)
- it increases heart muscle oxygen demand by at least 10%
- it reduces coronary artery blood flow due to adrenaline release
- it diminishes blood flow in our smallest coronary collateral blood vessels
- it interferes with the medicines that heart patients take to prevent angina pain
- it alters the clotting mechanism of blood platelets
- it causes endothelial cell dysfunction in the lining of coronary arteries, with reduced ability to produce chemicals that dilate the arteries
Sir Richard Peto, known as the ‘rockstar epidemiologist’ from the University of Oxford, claims that smoking is the absolute biggest risk factor in heart disease. He suggests:
“If you want to kill yourself, start smoking early, and don’t quit.”
Many smokers are getting the message.They are so gobsmacked by suffering a cardiac event that they do indeed quit smoking, often right on the spot. No patches, no gum, no hypnosis, no support groups. But, surprisingly, about half of heart attack survivors who are smokers leave the hospital still hooked, even though researchers show consistently that this decision doubles the chances of suffering a repeat heart attack. See also: True or False? Most Smokers Need Help to Quit
Scientists at New York’s Feinstein Institute for Medical Research also claim that just weeks after quitting smoking, women show major reductions in several markers of inflammation (C-reactive protein, tumour necrosis factor, among others) that have been clearly associated with heart disease risk. Because smoking is known to promote inflammation, quitting cuts the risk of mortality for both heart and lung disease.
What are we waiting for? How many more hospital beds and state-of-the-art cardiac procedures and countless hours of clinical expertise will be wasted in treating smokers with repeat heart attacks that are so clearly self-inflicted? Why aren’t all smokers being given mandatory smoking cessation programs while they are still essentially held captive in cardiac wards, thus forced to begin their future as ex-smokers?
The American College of Cardiology confirmed last year that a 10-year study following the progress of smokers who suffered heart attacks showed a remarkable decrease in the likelihood of a second heart attack among those patients who had participated in an intensive stop-smoking education program while still in hospital.
Dr. Patricia Smith of the Northern Ontario School of Medicine reported in the Canadian Medical Association Journal that three factors appear to influence the longterm success in quitting post-heart attack. In addition to receiving the intensive intervention in hospital, successful longterm results were also influenced by:
- the absence of a previous acute heart attack
- having a post-secondary education
- restrictions on smoking at home
I’d interpret that last important factor as blanket permission to lay down the law at home if you have a smoking heart patient anywhere under your roof. (Cities that have legislated bans on smoking in public places have been remarkably effective in getting smokers to quit just by making it so darned difficult to find a place that tolerates them).
But isn’t a quit-smoking program that starts while a heart patient is still hospitalized just another added financial burden on the health care system?
Think of the cost as a small investment in health now compared to the big cost of treating future heart attacks later, says an earlier study from Norway.
In other words, we can’t afford not to offer smoking cessation programs in cardiac wards.
Their study found that program costs compare favourably to other standard treatments for heart patients in hospital. For example, such programs would be approximately 1/25 the cost of offering both statins and ACE inhibitor drugs (both commonly given to cardiac patients).
The Norwegian conclusion: a nurse-led smoking cessation program with several months of intervention is very cost-effective compared with other treatments in patients with coronary heart disease.
Find out more about the Canadian Medical Association Journal study.
© Carolyn Thomas www.myheartsisters.org
NEWS UPDATE: In case you need any more ammunition, read this report presented at the European Society of Cardiology’s annual congress in Paris, August 2011: or this report called “The Role of Cigarette Smoking and Gender in Acute Coronary Syndrome“ published in the American Journal of Cardiology.
- True or False? Most Smokers Need Help to Quit
- Why Don’t Patients Listen to Doctors’ Heart-Healthy Advice?
- Why the Poor Pay Virtually No Attention to Quit Smoking Campaigns
- Too Many Smokers Are Quitting on their Own – so Pfizer Pays Doctors to Plug Their Nicorette Gum
- Cigarette Smoking a Greater Risk for Women’s Heart Health - The Lancet
- Stop-Smoking Drug Chantix/Champix Linked to Heart Risks – Canadian Medical Association Journal