Anti-smoking message saves heart patients’ lives

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Counseling people who have survived a heart attack about quitting smoking before they have even checked out of the hospital appears to reduce their risk of dying up to one year after the attack, new research reports.

U.S. investigators found that patients who received counseling about quitting smoking were nearly 20 percent more likely to survive the 30 days after the heart attack, and also more likely to live for an additional year.

These results suggest that anti-smoking counseling works, and people start reaping the benefits of quitting smoking within days after a heart attack, study author Dr. Thomas K. Houston of the University of Alabama at Birmingham told AMN Health.

Houston explained that cigarettes contain chemicals that disappear from the body soon after quitting. One of those chemicals, carbon monoxide, is known to increase the risk of life-threatening heart rhythms, which are also common after a heart attack, he noted.

“Thus, hypothetically, quitting smoking leads to decreased carbon monoxide, which thus leads to decreased risk of dangerous rhythms, which leads to lower risk of dying after a heart attack,” he said.

“Every heart attack patient who is a smoker should get counseling,” Houston added.

Previous research shows that quitting smoking after a heart attack can increase survival over the long term. And while further studies suggest that nearly 40 percent of people quit smoking after a heart attack, most appear to relapse within one year.

To investigate whether counseling people on how to quit smoking reduces their risk of dying, Houston and his team reviewed information collected from 16,743 smokers admitted to the hospital after a heart attack.

Medical records showed that 40 percent of patients received counseling about quitting smoking while at the hospital, the authors report in the American Journal of Medicine. Compared to smokers who didn’t get counseling, those who did were less likely to die within 30 days, 60 days and one year.

These findings suggest that even if patients can’t butt out for good, just spending a few months smoke-free after a heart attack can mean a difference between life and death, Houston noted.

He cautioned that the study didn’t measure whether people who received counseling were more likely to actually quit smoking, and therefore only links survival to counseling itself, not quitting smoking.

Houston also explained that counseling may help people quit because after a heart attack, they may be more willing to heed the advice of a medical professional.

During counseling, healthcare providers should ask patients if they smoke and, if they do, ask them to quit and give them tools to help them if they appear willing to try, Houston noted. It’s also important to schedule follow-up appointments with quitters to make sure they don’t relapse, he added.

“Hospitals should have policies to standardize smoking cessation counseling and documentation of the counseling, so that no patients are missed,” Houston recommended.

SOURCE: The American Journal of Medicine, March 2005.

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