REVIEW ER 'S CONCLUSIONS Quitting smoking is associated with a substantial reduction in risk of all-cause mortality among patients with CHD .
This 36 % risk reduction appears substantial compared with other secondary preventive therapies such as cholesterol lowering which have received greater attention in recent years .
The risk reduction associated with quitting smoking seems consistent regardless of differences between the studies in terms of index cardiac events , age , sex , country , and time period .
BACKGROUND Although the importance of smoking as a risk factor for coronary heart disease is beyond doubt , the speed and magnitude of risk reduction when a smoker with coronary heart disease quits are still subjects of debate .
OBJECTIVES To estimate the magnitude of risk reduction when a patient with CHD stops smoking .
Smoking cessation following admission to a coronary care unit
Objective : To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting . Design : Prospect i ve observational study in which smokers admitted to a coronary care unit ( CCU ) were followed for one year after hospital discharge to determine subsequent smoking behavior . Setting : Coronary care unit of a teaching hospital . Patients : Preadmission  smoking status was assessed in all 828 patients admitted to the CCU during one year . The 310 smokers surviving to hospital discharge were followed and their smoking behaviors assessed by self-report at six and 12 months . Intervention : None . Measurements and main results : Six months after discharge , 32 % of survivors were not smoking ; the rate of sustained cessation at one year was 25 % . Smokers with a new diagnosis of coronary heart disease ( CHD ) made during hospitalization had the highest cessation rate ( 53 % vs. 31 % , p=0.01 ) . On multivariate analysis , smoking cessation was more likely if patients were discharged with a diagnosis of CHD , had no prior history of CHD , were lighter smokers ( < 1 pack/day ) , and had congestive heart failure during hospitalization . Among smokers admitted because of suspected myocardial infa rct ion ( MI ) , cessation was more likely if the diagnosis was CHD than if it was noncoronary ( 37 % vs. 19 % , p<0.05 ) , but a diagnosis of MI led to no more smoking cessation than did coronary insufficiency . Conclusion : Hospitalization in a CCU is a stimulus to long-term smoking cessation , especially for lighter smokers and those with a new diagnosis of CHD . Admission to a CCU may represent a time when smoking habits are particularly susceptible to intervention . Smoking cessation in this setting should improve patient outcomes because cessation reduces cardiovascular mortality , even when quitting occurs after the onset of CHD
REVIEW ER 'S CONCLUSIONS Quitting smoking is associated with a substantial reduction in risk of all-cause mortality among patients with CHD .
This 36 % risk reduction appears substantial compared with other secondary preventive therapies such as cholesterol lowering which have received greater attention in recent years .
The risk reduction associated with quitting smoking seems consistent regardless of differences between the studies in terms of index cardiac events , age , sex , country , and time period .
BACKGROUND Although the importance of smoking as a risk factor for coronary heart disease is beyond doubt , the speed and magnitude of risk reduction when a smoker with coronary heart disease quits are still subjects of debate .
OBJECTIVES To estimate the magnitude of risk reduction when a patient with CHD stops smoking .