Quitting smoking adds the same number of heart disease-free years to life as three preventive medications combined, according to new research presented at ESC Preventive Cardiology 2022, a scientific congress of the European Society of Cardiology (ESC).[1]
“The benefits of smoking cessation are even greater than we realized,” said study author Dr. Tinka Van Trier of Amsterdam University Medical Centre, the Netherlands. “Our study shows that kicking the habit appears to be as effective as taking three medications for preventing heart attacks and strokes in those with a prior heart attack or procedure to open blocked arteries. Patients could gain nearly five years of healthy life.”
“This analysis focused on smokers who had experienced a heart attack and/or undergone stent implantation or bypass surgery,” she added. “This group is at particularly high risk of having another heart attack or a stroke and stopping smoking is potentially the most effective preventive action.”
The study used data from 989 patients aged 45 years and older who had a heart attack and/or underwent stent implantation or bypass surgery and were still smoking six months later. The average age was 60 years and 23% were female. Patients were generally well treated with standard preventive medications (antiplatelets, statins, and blood pressure-lowering drugs). The median time since the heart attack or procedure was 1.2 years.
Comparative Analysis of Smoking Cessation and Medications
The researchers used the SMART-REACH model (available at u-prevent.com) to estimate the gain in healthy years, i.e. without a heart attack or stroke, if patients quit smoking. They also calculated the gain in healthy years if patients continued smoking but took three additional drugs to prevent cardiovascular disease. The three medications included bempedoic acid and PCSK9 inhibitors, which lower LDL (“bad”) cholesterol, and colchicine, an anti-inflammatory therapy.
The researchers found that the estimated benefit of quitting smoking appeared to be comparable to using all three pharmaceutical treatments. Smoking cessation resulted in a gain of 4.81 event-free years while the three medications together provided a gain of 4.83 event-free years.
“This indicates that smoking cessation is a very important step towards adding healthy years to one’s lifetime,” said Dr. Van Trier. “It is important to remember that the analysis did not even account for the other advantages of giving up the habit – for example on respiratory illnesses, cancer, and longevity.”
She continued: “Smoking cessation remains a cornerstone of preventing heart attacks and strokes and improving overall health at any time, including after a heart attack and at any age. We know that cigarette smoking is responsible for 50% of all avoidable deaths in smokers, of which half are due to cardiovascular disease.[2] Giving up cigarettes after a heart attack is linked with improved survival compared with persistent smoking.”[3]
Dr. Van Trier concluded: “If you are considering becoming smokefree, or would like more information about it, please talk to a health professional. Your motivation is key to successfully quitting, but beating an addiction becomes easier with medical and psychological assistance.”
References and notes
- The abstract ‘Overall benefits of smoking cessation in patients with ASCVD are underestimated’ was presented during ‘Moderated posters session 1 – Secondary Prevention and Rehabilitation’ which took place on April 7 at 17:05 CEST.
- “2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC)” by Frank L J Visseren, François Mach, Yvo M Smulders, David Carballo, Konstantinos C Koskinas, Maria Bäck, Athanase Benetos, Alessandro Biffi, José-Manuel Boavida, Davide Capodanno, Bernard Cosyns, Carolyn Crawford, Constantinos H Davos, Ileana Desormais, Emanuele Di Angelantonio, Oscar H Franco, Sigrun Halvorsen, F D Richard Hobbs, Monika Hollander, Ewa A Jankowska, Matthias Michal, Simona Sacco, Naveed Sattar, Lale Tokgozoglu, Serena Tonstad, Konstantinos P Tsioufis, Ineke van Dis, Isabelle C van Gelder, Christoph Wanner, Bryan Williams, ESC Scientific Document Group, 30 August 2021, European Heart Journal.
DOI: 10.1093/eurheartj/ehab484 - “Smoking status and long-term survival after first acute myocardial infarction a population-based cohort study” by Yariv Gerber, Laura J. Rosen, Uri Goldbourt, Yael Benyamini, Yaacov Drory and Israel Study Group on First Acute Myocardial Infarction, December 2009, Journal of the American College of Cardiology.
DOI: 10.1016/j.jacc.2009.09.020
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