Chapter 31: Preventing and Mitigating Smoking-Related Heart Disease
What percentage of smokers interested in quitting are reported to have received tobacco cessation medication during outpatient physician office visits?
The answer is D. (Hurst’s The Heart, 14th Edition, Chap. 31) Even though 69% of smokers are interested in quitting (option A) and over half report having made a quit attempt in the past year (option B),1 only 21% of adult current tobacco users received tobacco cessation counseling (option C) and 8% received tobacco cessation medication during outpatient visits (option D).2 Screening for interest in tobacco cessation is particularly important because physician advice to quit smoking is associated with increased smoking cessation compared to no advice to quit or usual care, with higher cessation seen with more intensive advice compared to minimal advice.3 It is important that screening be incorporated into all clinical encounters, including those with cardiologists and other specialists, not only to identify and assist patients who are ready to stop smoking, but also to encourage those who are not yet ready to move toward making the decision to quit.
Which of the following statements about the cardiovascular benefits of smoking cessation is false?
A. In one year following smoking cessation, half the excess risk of a myocardial infarction is gone
B. Smoking cessation before the age of 30 years eliminates nearly all the risk of death from smoking-related disease
C. The risk of cardiac events drops approximately one month after quitting smoking
D. Those who quit when they are older gain years of life compared to those who continue to smoke
E. The risk of myocardial infarction and other cardiac events drops 15% to 20% by a month after implementing comprehensive smoke-free laws to protect people from secondhand smoke
The answer is C. (Hurst’s The Heart, 14th Edition, Chap. 31) In addition to contributing to the long-term development of atherosclerosis, smoking (and secondhand smoke exposure) has immediate effects (within minutes) on endothelial function4,5 and platelet activation6 and so can trigger a cardiac event. The risk of cardiac events begins to drop immediately after quitting and declines rapidly (option C). The heart rate drops 20 minutes after quitting, and in a year, half the excess risk of a myocardial infarction is gone (option A). The risk of myocardial infarction and other cardiac events drops ...