scholarly journals Smoke cessation in cardiovascular pathology from the perspective of evidence-based medicine

Author(s):  
O. A. Sukhovskaya ◽  
N. V. Kulikov

The effectiveness of smoking cessation methods has been studied in various studies. However, little is known about the peculiarities of treatment of nicotine dependence in patients with cardiovascular diseases. In the presented review, according to the literature, the prevalence and characteristics of smoking, the duration of abstinence from smoking in patients with cardiovascular diseases with different methods of quitting tobacco use are described.It is shown that smoking cessation not only shows long-term positive effects, but almost immediately the supply of cells with oxygen increases, platelet aggregation, fibrinogen synthesis decreases. Carrying out treatment for nicotine addiction, especially when combined with behavioral support, significantly increases the effectiveness of quitting smoking. With the cardiovascular pathology, the efficacy and safety of varenicline has been proven.

2016 ◽  
Vol 130 (21) ◽  
pp. 1929-1937 ◽  
Author(s):  
Fabio Cibella ◽  
Davide Campagna ◽  
Pasquale Caponnetto ◽  
Maria Domenica Amaradio ◽  
Massimo Caruso ◽  
...  

Quitting smoking is the most important step smokers can take to improve their health. Nonetheless, there is little information on long-term improvements in lung function and/or respiratory symptoms after smoking cessation. Here we illustrate long-term changes in spirometric indices as well as in respiratory symptoms in smokers invited to quit or reduce their cigarette consumption by switching to electronic cigarettes (ECs). Prospective evaluation of cigarette consumption, spirometry and symptoms was performed in a 1-year randomized controlled trial of smokers receiving EC containing 2.4%, 1.8% or 0% nicotine. Spirometric data are presented on the basis of participants’ pooled continuous smoking phenotype classification (Quitters, Reducers, Failures), whereas respiratory symptoms on the basis of their point prevalence-smoking phenotype. Smoking phenotype classification (Quitters, Reducers, Failures) had no significant effect on spirometric indices (FEV1, FVC and FEV1/FVC) with the exception of FEF25–75%, which significantly (P  =0.034) increased over the time among Quitters; their FEF25–75% (% predicted) improving from (means±S.D.) 85.7±15.6% at baseline (BL) to 100.8±14.6%. High prevalence of cough/phlegm (43.1%) and shortness of breath (SoB; 34.8%) was reported at BL with substantial reduction in their frequency at subsequent follow-up visits. These symptoms virtually disappeared very quickly in both quitters and reducers. Smokers invited to switch to ECs who completely abstained from smoking showed steady progressive improvements in their FEF25–75%. Normalization of peripheral airways function was associated with improvement in respiratory symptoms, adding to the notion that abstaining from smoking can reverse tobacco harm in the lung.


2017 ◽  
Vol 13 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Camille Alexis-Garsee ◽  
Hazel Gilbert ◽  
Martha Burton ◽  
Olga van den Akker

Introduction: Smokers with respiratory diseases are less likely to quit than those without impaired lung function, yet few studies have investigated the effectiveness of smoking cessation interventions with this population, and none have used a computer-tailored approach.Aims: This paper aims to fill this gap in the literature by exploring smokers’ experiences when trying to quit and their perceptions of a computer-tailored intervention.Methods: Semi-structured interviews were conducted with 26 smokers recruited from six general practises in North London. Thematic analysis was conducted to examine participants’ previous experiences of quitting and their perceptions of receiving personal tailored feedback reports to aid smoking cessation.Results: Participants discussed how their positive smoking experiences coupled with their negative cessation experiences led to conflicts with quitting smoking. Although the computer-tailored intervention was key in prompting quit attempts and participants valued its personal approach; it was not sufficient as a stand-alone intervention.Conclusions: The results highlight the difficulties that smokers experience when quitting and the need for a more personalised stop smoking service in smokers with respiratory diseases. The study also demonstrates the application and potential for computer-tailored intervention as part of a wider programme of long-term smoking cessation.


Heart ◽  
2021 ◽  
pp. heartjnl-2021-318972
Author(s):  
Xiaowen Wang ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kokoro Shirai ◽  
...  

ObjectiveTo examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.MethodsA total of 69 910 participants (29 650 men and 46 260 women) aged 45–74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1–5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.ResultsWe identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1–5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.ConclusionsPostcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD.


2020 ◽  
Vol 99 (10) ◽  
pp. 1120-1126
Author(s):  
Olga V. Naumova ◽  
Irina V. Kudaeva ◽  
Lyudmila B. Masnavieva ◽  
Olga A. Dyakovich

Introduction. Exposure to mercury and its compounds can be a risk factor for the development of cardiovascular diseases. The aim of the study is to investigate the levels of antibodies to oxidized LDL, intercellular adhesion molecules sICAM-1, sVCAM-1, and VEGF in individuals exposed to mercury. Material and Methods. A cross-sectional examination was carried out using biochemical methods in persons who have come into contact with metallic mercury with a work experience of more than five years, persons with a first established diagnosis of chronic mercury intoxication, and patients with chronic mercury intoxication in the long-term postexposure period. Results. In persons exposed to mercury with concomitant cardiovascular diseases, the level of sVCAM-1 differed depending on the presence/absence of intoxication and acquired maximum values in its long-term period, while the concentrations of sICAM-1 and antibodies to oxidized LDL did not differ significantly. In the groups without cardiovascular pathology exposed to mercury, the concentration of sVCAM-1 was higher in patients with intoxication, and sICAM-1 was 1.5-2 times lower when compared with experienced individuals, the level of antibodies to oxidized LDL was maximum in the presence of intoxication in its initial period. Discussion. The progression of chronic mercury intoxication is accompanied by an increase in the level of sVCAM-1, and a gradual decrease in the content of sICAM-1 to reference values. Trained workers were found to have elevated sICAM-1 levels. Conclusion. The role of antibodies to oxidized LDL, intercellular adhesion molecules is their multidirectional participation in the mechanisms that inhibit or contribute to the formation of cardiovascular pathology in individuals exposed to mercury.


2018 ◽  
Vol 21 (11) ◽  
pp. 1473-1479 ◽  
Author(s):  
Seung-Kwon Myung ◽  
Joo-Young Park

Abstract Introduction This study aimed to evaluate the efficacy of pharmacotherapy for smoking cessation among adolescent smokers by using a meta-analysis of randomized controlled trials (RCTs). Methods PubMed, EMBASE, and Cochrane Library were searched from the inception to January 20, 2018. We included RCTs of pharmacotherapy for smoking cessation among adolescent smokers aged less than 20 years. Data were pooled using a random-effects meta-analysis. The primary outcome measures were a smoking abstinence rate and its relative risk (RR) at the longest follow-up period in each study validated by biochemical markers. Results Among a total of 1035 articles searched, nine RCTs, which involved 1188 adolescent smokers aged 12–20 years with 627 in the intervention group and 561 in the control group, were included in the final analysis. In the random-effects meta-analysis of all the nine trials, pharmacotherapy showed a increased abstinence rate (RR = 1.62; 95% confidence interval [CI] = 1.08 to 2.44, I2 = 0.0%), compared with the control group. Subgroup meta-analyses by follow-up period showed an increased abstinence rate at 4 weeks (RR = 1.87; 95% CI = 1.22 to 2.87; n = 4) and a nonsignificantly increased abstinence rate during the longer term follow-up periods at 8, 12, 24, and 52 weeks. Conclusions The current meta-analysis suggests that pharmacotherapy can be considered as an aid for smoking cessation in the short-term period among adolescent smokers. However, further large RCTs are warranted to determine its long-term efficacy and safety. Implications In this meta-analysis of nine RCTs with 1188 adolescent smokers aged 12–20 years, pharmacotherapy showed an increased abstinence rate, compared with the control group. In the subgroup meta-analyses by follow-up period, it showed the increased abstinence rate at 4 weeks and no efficacy on abstinence during the longer term follow-up periods up to 52 weeks. Further large RCTs are warranted to determine the long-term efficacy and safety of pharmacotherapy in adolescent smokers.


2019 ◽  
Vol 22 (9) ◽  
pp. 1560-1568 ◽  
Author(s):  
Shannon Lea Watkins ◽  
Johannes Thrul ◽  
Wendy Max ◽  
Pamela M Ling

Abstract Introduction Young adults have high combustible cigarette and e-cigarette use rates, and low utilization of evidence-based smoking cessation strategies compared to older adults. It is unknown whether young adults who try to quit smoking without assistance, with evidence-based strategies, or with e-cigarettes, are equally successful compared to older adults. Aims and Methods This analysis used a population-based sample from the Population Assessment of Tobacco and Health study of young adult (aged 18–24, n = 745) and older adult (aged 25–64, n = 2057) established cigarette smokers at Wave 1 (2013–2014) who reported having made a quit attempt at Wave 2 (2014–2015). Cessation strategies were: behavioral therapy, pharmacotherapy, product substitution, 2+ strategies, and unassisted. Logistic regression estimated associations between cessation strategy and short-term cessation status at Wave 2 (quit, no quit); multinomial logistic regression predicted long-term cessation patterns at Waves 2 and 3 (sustained quit, temporary quit, delayed quit, no quit). Results No cessation strategy (ref: unassisted) significantly predicted short-term cessation. No cessation strategy (ref: unassisted) significantly predicted long-term cessation patterns for young adults. Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day (adjusted odds ratio [AOR]: 1.70; 95% confidence interval: 1.08, 2.67) but did not predict long-term cessation patterns. Conclusions Despite differences in cessation strategy use between young and older adult smokers, strategy effectiveness largely did not differ by age group. No strategy examined, including e-cigarettes, was significantly associated with successful cessation for young adults. More work is needed to identify effective interventions that help young adult smokers quit. Implications (1) Neither behavioral support, pharmacotherapy, nor product substitution was associated with short-term cessation for young or older adults compared to quitting unassisted. (2) Neither behavioral support, pharmacotherapy, nor product substitution was associated with longer-term cessation for young or older adults compared to quitting unassisted. (3) Substitution with e-cigarettes predicted short-term cessation for older daily smokers of ≥5 cigarettes/day but was not associated with longer-term cessation.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Dorota Kaleta ◽  
Bukola Usidame ◽  
Elżbieta Dziankowska-Zaborszczyk ◽  
Teresa Makowiec-Dąbrowska

Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults.Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression.Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P<0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders.Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.


2017 ◽  
Vol 8 (3) ◽  
pp. 39-4
Author(s):  
M. G Bubnova

The presented review concerns the problem of lifestyle changes in primary and secondary prevention of cardiovascular diseases. The results of studies highlighting the positive effects of quitting smoking, controlling blood pressure, body weight and cholesterol on the risks of developing cardiovascular diseases and their complications are highlighted. Attention is paid to the principles of the formation of a healthy diet and increased physical activity. The principles of prescribing statins with different categories of cardiovascular risk of the patient with emphasis on the new statin - pitavastatin are indicated.


2021 ◽  
pp. tobaccocontrol-2020-056448
Author(s):  
Bekir Kaplan ◽  
Panagis Galiatsatos ◽  
Alison Breland ◽  
Thomas Eissenberg ◽  
Joanna E Cohen

BackgroundResearch is inconclusive on the effectiveness of electronic nicotine delivery systems (ENDS) as cigarette cessation aids compared with nicotine replacement therapy (NRT) or non-NRT medication. This study compared the cigarette cessation rates for ENDS, NRT and non-NRT medication.MethodPopulation Assessment of Tobacco and Health Study wave 3 cigarette-only users who used ENDS, NRT or non-NRT medication (varenicline and bupropion) to quit smoking between wave 3 and 4 were included. ‘Cessation’ was defined as being a former cigarette smoker in wave 4. χ2, logistic regression, and a sensitivity analysis with Bayes factor assessed the association between quitting smoking and method used.ResultsAmong 6794 cigarette-only users, 532 used ENDS (n=75), NRT (n=289), non-NRT medication (n=68), or a combination of NRT and non-NRT medication (n=100) to quit smoking between wave 3 and 4. The percentages of quitting smoking among those who used ENDS, NRT, non-NRT medication, and a combination of NRT and non-NRT medication were 16.2% (n=14), 16.1% (n=47), 17.7% (n=13), and 14.8% (n=12), respectively (p=0.97). None of the cigarette-only users who used ENDS to quit smoking became ENDS-only users in wave 4; 37.6% became dual users of ENDS and cigarettes.ConclusionNo differences were found when cessation rates of ENDS, NRT or non-NRT medication were compared. Given uncertainty about the long-term health effect of ENDS and the likelihood of becoming dual users, people who smoke and need assistance quitting should be encouraged to use current Food and Drug Administration-approved cessation methods until more effective methods are developed.


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