doctors should seize every opportunity to encourage patients to stop smoking

Although many cardiovascular
diseases (CVDs) can be treated or prevented, an estimated 17.1 million people die of CVDs each year. A substantial number of these deaths can be attributed to tobacco smoking, which increases the risk of dying from coronary heart disease and cerebrovascular disease 2–3 fold. The risk increases with age and is greater for women than for men. In contrast, cardiac events fall 50% in people who stop smoking and the risk of CVDs, including acute myocardial infarction, stroke and peripheral vascular disease, also decreases significantly over the first two years after stopping smoking. Continuing to smoke after myocardial infarction or coronary revascularization can have serious clinical consequences. Even eight years after myocardial infarction, the mortality of post-myocardial infarction patients who continue to smoke is double that of quitters. Further, those who do not stop smoking after coronary revascularization also have a two-fold higher risk of re-infarction and death.