Everything in moderation is usually sage advice. Often times even a little overindulgence is OK. However, neither of these are all right when it comes to smoking and cardiovascular disease. Quitting smoking decreases your heart attack risk by at least half, but cutting down does not change your risk.
Cardiovascular disease, in particular, can be improved by quitting smoking. Other body systems may not fare so well. The amount of information available is too extensive for this article.
A recent study presented at the European Society of Cardiology, which included 32,378 cardiac patients over a six-year period, showed a 44% decrease in the risk of major cardiovascular events, including death and heart attack, over a five-year period. Continuing to smoke, even if reduced, added a yearly 8% increased risk of cardiovascular events.
Smoking damages the lining of the arteries, which causes atherosclerosis. This is a buildup of fats, cholesterol and other substances in and on the artery walls, leading to heart attack and heart failure. The arteries narrow, reducing the blood flow and oxygen to the heart. Smoking also increases blood clotting, putting one more at risk. Nicotine causes vasoconstriction (tightening) of the coronary arteries, adding to decrease in blood flow. Smoking also causes an inflammatory response of the arteries causing further risk.
Richard Wright, M.D., cardiologist at Providence St. John’s Health Center in Santa Monica, states, “There is no safe level of cigarette smoking. The noxious components of smoke immediately lead to a chain of noxious events, and whether one smokes a quarter-pack or two packs of cigarettes is irrelevant with regards to the increase in cardiac risk. This enhanced risk also extends to those exposed to second-hand smoke.”
Studies have shown these dangers are worse for women. Women’s coronary arteries are generally smaller. Peri-menopause and menopause puts one at higher risk. Diseases such as obesity and diabetes also contribute negatively.
The study also found the first year after an event is a key window of opportunity to encourage smoking cessation. Patients were found to be more receptive and have success in quitting.
Dr. Jules Messier, author of the study, states, “It is never too soon or too late to stop smoking, though the sooner a patient stops, the better to lower cardiovascular risk.” He advocates support for quitting by giving short, clear messages at every medical intervention highlighting the need to quit. The message that they can cut their risks in half is a powerful one: “Measures to promote smoking cessation include brief advice, counseling, behavioral interventions, as well as pharmacological therapy.”
People with or without cardiovascular disease are advised to stop smoking as soon as possible. A strong message to youth to never start is that people who have never smoked have a lower overall risk of a major cardiovascular events than a person who quit smoking.
The commonwealth of Massachusetts offers many resources to help quit smoking. Call 800-QUIT-NOW, or enroll online at Mass.gov. The program offers a free trained quit coach online or by phone, steps and advice to quit, guidance on quit medicines and insurance coverage. They also offer advice for friends, family and providers to help someone quit. Other organizations with cessation programs include the American Heart Association, American Lung Association and American Cancer Society.
One can’t turn the television on without a moving, brutally honest commercial of a poor soul suffering from the effects of smoking, hoping to spread the message they learned too late. The risk of smoking facts are clear. You only have one life and one body. Protect it from smoking and second-hand smoke.
Take care of yourself and someone else.
Juanita Carnes is a Westfield resident and a nurse practitioner with 38 years of experience in a hospital emergency department and urgent care facilities. She served 30 years on the Westfield Board of Health.
