Many adults with cardiovascular disease are aware of the risks, but do not quit

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Many adults with a history of cardiovascular disease (CVD) continue to smoke cigarettes and / or use other tobacco products, despite knowing that it increases the risk of having another cardiovascular event, according to new research published today in Journal of the American Heart Association.

To understand how many adults with CVD continue to use products, the researchers reviewed the responses to surveys in the comprehensive national study on tobacco population and health assessment (PATH) to compare tobacco consumption rates over time. Participants in the current study included 2,615 adults (over the age of 18) with a history of heart attack, heart failure, stroke, or other heart disease, who completed four surveys over a four- to five-year period.

The first survey was conducted from 2013 to 2014 and the last from 2016 to 2018. When the study began, almost half of the study participants were women (48.5%); of the self-identified responses, 77% were white adults, 10.5% were black adults, 8% were Hispanic adults, and the rest were multiracial or otherwise. Between 2013 and 2014, nearly a third of study participants (28.9%) reported smoking. This percentage translates into approximately 6 million American adults who use tobacco despite a history of BCV.

Among the tobacco products used by the study participants:

  • Cigarettes were the most common form of tobacco use (82.8%), followed by any type of cigar (23.7%) and electronic cigarettes (23.3%). Many participants used more than one type of tobacco product.
  • The use of e-cigarettes without simultaneous cigarettes among participants with CVD was uncommon (1.1%).
  • 8.2% of participants reported the use of smokeless tobacco products.
  • Use of others it was uncommon: pipe = 3.7%; hookah = 3.0%; snus (a smoke-free Swedish tobacco product) = 1.2%; and solvent tobacco = 0.3%.

In the final survey, four to five years later, less than a quarter of smokers with MCV quit smoking. Participation in a formal smoking cessation program decreased from 10% of respondents during the second wave of the survey to approximately 2% at the end of the study.

“At the end of our study, we were surprised that so few users of cigarettes with cardiovascular disease were part of a formal smoking cessation program,” said study co-author Cristian Zamora, MD, FAHA, resident of third years in internal medicine at Jacobi Medical Center at the Albert Einstein College of Medicine in the Bronx, New York. “It was also worrying that despite the well-documented benefits of quitting smoking after a diagnosis of MCV, few people had quit smoking over the five-year study.”

Among the other notable findings:

  • Most study participants with CVD (95.9%) reported that they knew or believed that smoking can cause heart disease in smokers.
  • A significant proportion of study participants (40.2%) said they believed e-cigarettes were less harmful than combustible cigarettes.
  • The use of e-cigarettes varied depending on the general perception of the harmfulness of e-cigarette use compared to cigarette smokers.
  • The prevalence of use and dual use (smoking combustible cigarettes and e-cigarettes) was higher among participants who said they believed e-cigarettes were less harmful than cigarettes, compared to those who believed e-cigarettes were more harmful. than cigarettes.
  • Dual use of cigarettes and e-cigarettes was more common among study participants than use of e-cigarettes alone.

“In the United States, heart disease is the leading cause of death, accounting for more than 365,000 deaths in 2018. One of the leading risk factors for cardiovascular disease, including heart events and stroke, is smoking.” , said Rose Marie Robertson, MD, FAHA, deputy scientific and medical director of the American Heart Association, who did not participate in this study, but is the co-director of the Association’s Tobacco Center for Regulatory Sciences. in the studio. “Fortunately, research clearly shows that quitting smoking can help prevent heart disease, even among people who have had it in the past. The findings of this new study are disturbing, though perhaps not surprising. These results indicate that critical public policies and interventions are needed to address this major preventable cause of death and disability, not just in the United States, but around the world. “

Trends in tobacco use varied by gender, age, race / ethnicity, and other socioeconomic characteristics of study participants:

  • Among adults with MCV, the use of any tobacco product was associated with a younger age.
  • Men were more likely than women to use any tobacco product except e-cigarettes.
  • Women were 70% more likely than men to use e-cigarettes.
  • Hispanic participants were 60% less likely than white participants and 50% less likely than black participants to use any tobacco product.
  • Lower income levels of households were associated with a higher likelihood of using any tobacco product.
  • Participants living below the poverty line (annual income of $ 23,550 in 2013 and $ 25,100 in 2018 for a family or household of four living in one of the 48 contiguous states or the District of Columbia) had twice as much odds of reporting using any tobacco product compared to those living with a double or higher poverty level.
  • There were no significant differences in the use of any tobacco product among adults with MCV between U.S. regions

“Our findings support the need for a stronger commitment on the part of a multidisciplinary team, including the professional, social worker, psychologist and cardiologist, to provide smoking cessation therapies and counseling to people with cardiovascular disease, “Zamora said.” Health care reforms and public health policies should improve the availability of smoking cessation programs and tools for high-risk populations. “

The study has several limitations. The self-report of the participants’ past disease and tobacco use could be inaccurate. Another limitation is that relatively few adults reported smoking e-cigarettes, so the relationship between the past i it is not yet clear.


Use of electronic cigarettes plus tobacco cigarettes related to an increased risk of respiratory symptoms


More information:
Journal of the American Heart Association (2021). DOI: 10.1161 / JAHA.121.021118

Citation: Many adults with cardiovascular disease know the risks, even if they do not quit (2021, June 9), retrieved June 9, 2021 at https://medicalxpress.com/news/2021-06-adults-cardiovascular- disease-dont. html

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