Smoking After Heart Attack Raises Risk of Dying

"cigarrette smoking is really dangerous to our health"

MONDAY, July 25 -- People who resume smoking after hospitalization for a heart attack are more likely to die than those who quit for good, a new Italian study confirms.

The findings -- that patients who relapsed were three to five times more likely to die than those who stop -- suggest that doctors and hospitals need to do more to support long-term smoking-cessation efforts after discharge, the researchers said.

For the study, recently published in the American Journal of Cardiology, researchers followed 1,294 smokers hospitalized with symptoms of acute coronary syndrome, characterized by severe chest pain suggestive of a heart blockage or heart attack. The patients had stopped smoking while in the hospital.

The study team, from San Filippo Neri Hospital in Rome and La Colletta Hospital in Genoa, wanted to assess the smoking relapse rate and determine to what extent relapse might affect the patient's survival.

Cigarette smoking is a known cause of heart disease. By quitting, people who already have heart disease will reduce their risk of sudden cardiac death or a second heart attack, according to the U.S. National Heart, Lung, and Blood Institute. The chemicals in cigarette, cigar and secondhand smoke impede heart function and damage blood vessels.The men and women in the study, whose average age was 59.7, were followed for 12 months after discharge. While in the hospital, all had received some counseling about the effects of smoking and tips for quitting.Within a year, 97 patients died. Eighty-one of those deaths were from cardiovascular disease, the researchers found.

The researchers found that nearly two-thirds (62.8 percent) had resumed smoking, half of them within 19 days. Women and older people were most likely to relapse, the researchers said. Diabetics and patients who had participated in cardiac rehabilitation were the most likely to have quit. "In conclusion, smoking relapse after acute coronary syndromes is associated with increased mortality, and counseling interventions should be integrated into the post-discharge support to reduce the negative effects of smoking resumption," the authors wrote in the study abstract.

Some experts believe a successful stop-smoking strategy should include pharmaceuticals, such as nicotine patches, in addition to behavioral management tools.