More than half of smokers go on smoking after coronary events

Too many people with heart disease continue to smoke even after they are aware of their condition, say researchers in the European Heart Journal (published online 6 Oct 2005, doi: 10.1093/eurheartj/ehi497). Less than half the patients who smoked before needing hospital treatment for a coronary event quit afterwards.

Wilma Scholte op Reimer, lead author of the study and epidemiologist at the Erasmus University Medical Centre in Rotterdam, described the finding as “unbelievable.” “It makes me wonder if they are truly aware of the risk that they are taking,” she said.

The finding shows that smoking rates in heart patients have not changed since 1996, when a similar study was done. In the latest study, 21% of coronary patients were persistent smokers after treatment compared with 19% in the earlier study.

Figure 1.

Four of France's early heart transplant patients pictured in the 1970s after their operation. Three out of four continued to smoke

In the latest study, EUROASPIRE II, researchers looked at the clinical characteristics, including smoking, of 5551 coronary patients aged less than 70 from 15 European countries treated in hospital during 1999 and 2000.

The patients had been treated for myocardial infarction or angina or had had a coronary bypass or balloon angioplasty 16 months earlier. They were asked about their smoking habits before and after their admission to hospital; smoking status was confirmed with a test of the concentration of carbon monoxide in the breath.

Of the 2244 patients who smoked before their treatment, 48% succeeded in quitting. Older patients were most likely to quit. More than half (53%) of patients older than 60 stopped smoking compared with 41% aged younger than 50. Patients who were better educated, had had a myocardial infarction, were obese, and were still under the care of a cardiologist were also more likely to quit.