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Smoking 

Smoking
Chapter:
Smoking
Author(s):

Charlotta Pisinger

and Serena Tonstad

DOI:
10.1093/med/9780199656653.003.0010_update_001

Update:

  • Varenicline and bupropion do not appear to increase neuropsychiatric adverse events in subjects without psychiatric illness or with stable psychiatric illness

  • Varenicline is effective in smokers with acute coronary syndrome

  • Varenicline does not appear to increase CVD risk

  • Update regarding electronic cigarettes

Updated on 23 February 2017. The previous version of this content can be found here.
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date: 15 April 2021

Smoking causes all forms of cardiovascular disease (CVD): there is no safe level of smoking. The health benefits of quitting smoking are immediate. In patients with coronary heart disease smoking cessation results in a dramatic decline in future cardiovascular events and reduces cardiovascular death; it is the most effective and cheapest treatment for preventing new or recurrent CVD. Tobacco dependence should be regarded as a chronic disease with a lifelong risk of relapse. Making treatment readily available and reducing barriers to treatment increase the likelihood that smokers will accept treatment. Medication and follow-up should be arranged for all smokers upon hospital discharge and in outpatient settings. High priority should be given to identification and documentation of the smoking status of all patients, and systematic provision of cessation support. Clinicians should also ask about exposure to second-hand smoke and should play an active role in advocating for stronger tobacco controls.

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