Smoking cessation: lessons learned from clinical trial evidence
- 1 July 2007
- journal article
- review article
- Published by Wolters Kluwer Health in Current Opinion in Cardiology
- Vol. 22 (4), 280-285
- https://doi.org/10.1097/hco.0b013e328236740a
Abstract
Cigarette smoking and exposure to secondhand smoke cause coronary heart disease. Cessation dramatically reduces the incidence of primary and secondary cardiac events. The review presents up-to-date information regarding nicotine dependence, recent findings related to its treatment, and recommendations for addressing smoking cessation for the primary and secondary prevention of coronary heart disease. Bans on smoking in public places are associated with significant reductions in the incidence of acute myocardial infarction. Counseling and pharmacotherapy (nicotine replacement therapy, bupropion) are proven, effective treatments for nicotine dependence. Clinical trials of two new pharmacotherapies, varenicline and rimonabant, have recently been reported. Varenicline is a safe and efficacious medication for smoking cessation, and has been approved in the US, Canada and Europe. Rimonabant has shown mixed results for smoking cessation and is undergoing further evaluation. All patients should be screened for tobacco use. Clinicians can effectively treat nicotine dependence in the general population using counseling and first-line pharmacotherapies (nicotine replacement therapy, bupropion, varenicline). These same treatments, with some modification, are appropriate for smokers with coronary heart disease; however, brief interventions without follow-up are not effective in this population. For smokers with coronary heart disease, the best time to intervene may be during hospitalization.Keywords
This publication has 41 references indexed in Scilit:
- Promoting Smoking Cessation in the Healthcare Environment: 10 Years LaterAmerican Journal of Preventive Medicine, 2006
- Smoking Cessation 2: Behavioral TreatmentsBehavioral Medicine, 2006
- The Top Priority: Building a Better System for Tobacco-Cessation CounselingAmerican Journal of Preventive Medicine, 2006
- Nicotine and Non-nicotine Smoking Cessation PharmacotherapiesCardiology in Review, 2006
- Developments in pharmacotherapy for tobacco dependence: past, present and futureDrug and Alcohol Review, 2006
- Smoking Cessation and Cardiovascular Disease Risk Factors: Results from the Third National Health and Nutrition Examination SurveyPLoS Medicine, 2005
- Safety and effectiveness of transdermal nicotine patch in smokers admitted with acute coronary syndromesThe American Journal of Cardiology, 2005
- ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive SummaryJournal of the American College of Cardiology, 2004
- The pathophysiology of cigarette smoking and cardiovascular diseaseJournal of the American College of Cardiology, 2004
- Global Burden of Cardiovascular DiseasesCirculation, 2001