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Quitting smoking extends life after heart attack

Journal of the American College of Cardiology
December 2009

Quitting smoking extends life after heart attack

A new study finds that heart attack survivors who quit smoking live longer than those who keep puffing away. The study also found a survival advantage for smokers who did not quit but managed to cut down on cigarettes.

Quitting smoking has been shown to improve outcome after acute myocardial infarction. To asses how smoking cessation helps improving survival chances after heart attack, researchers followed 1,521 adults aged 65 years and older who were treated at one of eight Israeli hospitals for a first-time heart attack in 1992 or 1993. At the time, 27 percent had never smoked, 20 percent were former smokers, and more than half were current smokers. After hospital discharge, a majority of smokers tried to quit; 35 percent managed to remain continuously abstinent over the next 10 to 13 years.

A total of 427 patients died during the 13-year study period. The risk was greatest among those who had continued to smoke, even with factors like obesity, exercise habits, education and income, and overall health taken into account. It was found that while quitting smoking altogether was best, smokers who cut back after their heart attack also improved their outlook. Among the 381 patients who continued to smoke, the risk of dying during the study period declined by 11 percent for every five daily cigarettes they cut out.

Compared with first-time heart attack sufferers who continued to smoke, those who quit were 37 percent less likely to die during the study period. That was close to the risk reduction seen among heart attack survivors who had never smoked - who had a 43 percent lower risk of dying during the study than persistent smokers. Meanwhile, patients who had quit smoking sometime before their heart attack were half as likely to die during the study period as smokers who kept up the habit.

The findings support the earlier studies which suggested that offering heart attack patients smoking-cessation counseling can lower the risk of further complications.

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