A clinical imperative: assisting patients who smoke to reduce their risk of cardiovascular disease.
The role of tobacco smoking as a cause of cardiovascular disease is now unequivocal and well-documented in literally hundreds of epidemiologic and biomedical studies over the past 50 years. Cessation of smoking, on the other hand, swiftly and profoundly reduces the risks of a cardiovascular event. Thus, smoking cessation should be seen as perhaps the most effective lifesaving intervention in the physician's armamentarium. Despite this widely available knowledge, and evidence that most smokers want to quit, relatively few physicians offer cessation support to their smoking patients, even those at high risk for a cardiovascular event. This article reviews the links between tobacco smoking and cardiovascular disease, argues for a greater role for physicians in assisting smokers to quit, and highlights the most effective interventions currently available.
Bullen
Chris
C
Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand. c.bullen@ctru.auckland.ac.nz
Whittaker
Robyn
R
McRobbie
Hayden
H
Fagerström
Karl
K
D001552:Benzazepines / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D037001:Directive Counseling; D006760:Hospitalization; D006801:Humans; D014179:Neurotransmitter Uptake Inhibitors / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D009661:Nortriptyline / Q000627:therapeutic use; D011810:Quinoxalines / Q000627:therapeutic use; D012017:Referral and Consultation; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects* / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods*; D000068580:Varenicline
D001552:Benzazepines; D014179:Neurotransmitter Uptake Inhibitors; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D009661:Nortriptyline; D000068580:Varenicline