October 26, 2024, 1:49 pm | Read time: 4 minutes
We all know that smoking is not healthy. However, it is not only the lungs that suffer from tobacco consumption but also the heart. And what should you do if your GP diagnoses coronary heart disease? Is there any point in quitting smoking, or has the ship sailed? FITBOOK editor Sophie Brünke came across an exciting study that was recently presented at the ESC Congress 2024 in London.
The Federal Ministry of Health describes smoking as the greatest avoidable health risk in Germany. Every year, more than 127,000 people die in this country as a result. Fortunately, the proportion of smokers in the population has been falling since the 1980s. However, around a fifth of adults still consumed cigarettes in 2021.1 This puts their bodies at increased risk of cancer and cardiovascular disease. However, at this year’s European Society of Cardiology (ESC) congress, a study was presented that investigated the impact of quitting smoking on people already diagnosed with coronary heart disease. The results are promising.2
Overview
International registry study examined over 30,000 test subjects
Using the international CLARIFY registry (prospective, observational, longitudinal registry for patients with stable coronary heart disease), the scientists investigated the influence of smoking behavior on cardiovascular events in patients with coronary heart disease (CHD). The register contained data on 32,378 patients with this disease. The subject of the study was the occurrence of a heart attack or death as a result of CHD during a five-year observation period. To this end, the research team recorded the smoking history, the current smoking status of the patients, and the occurrence of the aforementioned consequences on an annual basis.
The study included both smokers and non-smokers
The patients were included in the study on average six and a half years after their CHD diagnosis. At the time of enrollment, 13,366 patients (41.3 percent) had never smoked. A further 14,973 participants (46.2 percent) were former smokers, and 4039 (12.5 percent) were current smokers.
Among former smokers who smoked at the time of their coronary heart disease diagnosis, 72.8 percent said they had quit smoking within the following year. The remaining former smokers (27.2 percent) quit in the following years.
Quitting smoking almost halves the risk of heart attack and death
All test subjects who stopped smoking after being diagnosed with CHD were able to reduce their risk of heart attack or cardiovascular death by a whopping 44 percent – regardless of when they stopped smoking. However, after a CHD diagnosis, the risk of both subsequent events also increased by eight percent annually if smoking had not yet been stopped.
Although smokers who stopped smoking achieved a rapid and significant risk reduction compared to smokers, they never reached the cardiovascular risk of subjects who had never smoked, even after years of smoking cessation.
The crucial time window for quitting smoking
Study author Dr. Jules Mesnier from the Hospital Bichat-Claude Bernard in Paris explained in a press release: “Interestingly, the first year after diagnosis was the crucial time window for quitting. At the time of diagnosis, we should emphasize the importance of quitting and support patients in this challenge.”3
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Merely smoking less instead of quitting yields fewer health benefits
Some smokers did not stop smoking after being diagnosed with heart disease but simply reduced the number of cigarettes they smoked each day. However, this measure did not have a significant effect.
It has already been established in the past that just one cigarette a day increases the risk of CHD and strokes.
Study author advocates for enhanced education for smokers
Dr. Mesnier explains: “I like to tell my patients that it is never too early or too late to stop smoking. However, the earlier a patient stops smoking, the better it is to reduce the cardiovascular risk.” He also emphasizes: “It is not enough to restrict smoking. Any medical intervention needs short, clear messages to smokers that emphasize the need to quit. Telling patients that they can halve their risk of a subsequent serious incident or death – as we have shown here – is a powerful message.”
So far, only a press release and the abstract of the study have been published, but not the full-length study in a scientific journal. Therefore, it is not currently possible to assess the strengths and weaknesses of the study. Accordingly, the encouraging results should nonetheless be taken with a grain of salt.