Addressing Smokers with Cardiovascular Disease

Using key concepts from the 2018 American College of Cardiology Expert Consensus Decision Pathway on Tobacco Cessation Treatment1

Approximately 30% of deaths in the US attributed to smoking are due to cardiovascular disease.2 Cigarette smoke exposure even at low levels or for short periods of time increase risk of cardiovascular disease.3 But smoking cessation has been shown to reduce cardiovascular events and mortality.4, 5 All smokers, regardless of amount or length of time smoked, comorbidities, or age, can benefit from smoking cessation, even if cessation occurs after the development of cardiovascular disease.

Cigarette smoking is a chronic relapsing substance use disorder caused by addiction to nicotine. Treating tobacco dependence, therefore, requires clinicians to adopt a chronic disease management strategy, monitoring tobacco use over time and making repeated efforts to encourage and assist smokers to quit using tobacco.6

In this video, we’ll watch a healthcare provider discuss the importance of cessation with a patient who has suffered from a myocardial infarction in the past. This doctor will follow the American College of Cardiology (ACC)’s guidance for treating smokers from the 2018 Expert Consensus Treatment Pathway on Tobacco Cessation. The significant relationship between cigarette smoking and cardiovascular disease provides a strong rationale for healthcare providers to take action to change this modifiable risk factor.



1. 2018 ACC Expert Consensus Decision Pathway on Tobacco Cessation Treatment. Rajat S. Barua, Nancy A. Rigotti, Neal L. Benowitz, K. Michael Cummings, Mohammad-Ali Jazayeri, Pamela B. Morris, Elizabeth V. Ratchford, Linda Sarna, Eric C. Stecker, Barbara S. Wiggins. J Am Coll Cardiol. 2018 Dec, 72 (25) 3332-3365.

2. Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion. Tobacco-Related Mortality.

3. Schane RE, Ling PM, Glantz SA. Health effects of light and intermittent smoking: a review. Circulation. 2010;121(13):1518–1522. doi:10.1161/CIRCULATIONAHA.109.904235. 

4. Hermanson B.O.G., Kronmal R.A., Gersh B.J (1988) Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease. Results from the CASS registry. N Engl J Med 319:1365–1369.

5. Meyers D.G., Neuberger J.S., He J. (2009) Cardiovascular effect of bans on smoking in public places: a systematic review and meta-analysis. J Am Coll Cardiol 54:1249–1255.

6. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.

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