August 15, 2011

Cigarette smoking is the most important preventable risk factor for CHD. It remains the major preventable cause of early death, disability, and health expense in the United States accounting for over 400,000 deaths each year. Estimates suggest that 11% of deaths in women are attributable to smoking and that one in four women smoke. The number of cigarettes smoked per day is directly related to cardiovascular events. Smoking as few as 1-4 or 5-14 cigarettes a day increases the risk of coronary events twoto threefold. Women in the Nurses’ Health Study who smoked more than 25 cigarettes a day had 5.5 times the risk of a fatal coronary event as women who did not smoke. In addition, smoking is a major contributor to the incidence of stroke and peripheral vascular disease (a disease of the blood vessels in the legs and arms). Nonetheless, it is estimated that 24% (48 million) American men and women continue to smoke and there has been an alarming trend toward an increase in the proportion of women smokers, particularly young women.

The need and benefits of smoking cessation cannot be overemphasized. Stopping cigarette smoking is a difficult task and often requires a multifaceted approach including patient education, pharmacologic agents as well as a close partnership between the patient and the health care provider. This is particularly important since data suggest that smoking cessation techniques are less effective in women and that women have higher relapse rates. There is a very important interaction between cigarette smoking and oral contraceptive (OCP) use. The risk of coronary disease in women who are smokers as well as users of OCPs is increased approximately 20to 30-fold above baseline and is 6-8 times higher than for those who smoke only. For that reason, use of OCPs should be avoided in smokers over the age of 35.

SEE ALSO: Acute myocardial infarction, Cardiovascular disease, Cholesterol, Diabetes, Exercise, Hormone replacement therapy, Hypertension, Nutrition, Smoking

Tags: ,

Category: Coronary Risk Factor