Impact of smoking cessation and smoking interventions in patients with coronary heart disease

Although it is well known that smoking is strongly associated with coronary heart disease, many patients continue or resume smoking after being diag- nosed with coronary heart disease and even after an important event such as a myocardial infarction, angio- plasty or coronary bypass surgery. The evidence that smoking causes cardiovascular disease and new events in patients with coronary heart disease, among other serious disorders such as lung cancer and emphysema, justifies the promotion of smoking cessation. All rec- ommendations on the prevention of coronary heart dis- ease emphasize the importance of smoking cessation in the reduction of the risk of coronary death and non-fatal coronary events[3,4]. The recent EUROASPIRE study on the status of secondary prevention of coronary heart disease in nine European countries has shown, however, that success in smoking cessation among coronary heart disease patients is far from satisfactory[5]. In this era of evidence-based medicine, information from systematic reviews of published studies should guide physicians and other health professionals advising patients in smoking cessation. With this in mind, we have carried out a systematic review of published observational studies on the impact of smoking cessation on the prognosis and on smoking intervention trials in patients with coronary heart disease.