The burden of cardiovascular disease due to ciga- rette smoking is enormous, both in the Western world and in developing countries. To stop smoking is healthy at all ages. This section not only focuses on the burden of disease, but also gives information on the latest guidelines to help patients quit smoking, based on the fact that dependency is the main factor that has to be over- come. Therefore, assisting the coronary patient to give up smoking remains one of the main tasks of comprehensive cardiac rehabilitation and all team members should have a basic knowledge in this field.
Main Messages
Chapter 27: The Burden of Smoking on Cardiovascular Disease
Among the risk factors for cardiovascular disease, smoking still ranks as main cause of premature coronary disease. In this chapter the present epi- demiology of smoking is described. The relation between both active and passive smoking and coronary heart disease (CHD) and the causal mechanisms are discussed. Severe consequences for public health are demonstrated.
Physicians and other health workers in the field of CHD prevention and rehabilitation should play an active role in smoking cessation.
Chapter 28: The Role of Tobacco Dependence and Addiction
In successful counseling of coronary patients on quitting smoking, physicians as well as other cardiac rehabilitation team members need to understand the role of dependence on and addic- tion to nicotine. This complex mechanism and the highly individual combination of contributing factors implies a diagnostic and therapeutic chal- lenge. The aim of this chapter is to give insight into the theoretical background of nicotine addic- tion and thus provide a basis for smoking cessa- tion as part of a cardiac rehabilitation program.
Chapter 29: Treatment of Tobacco Dependency
In most patients the traumatic experience of an acute cardiac event will be the starting point of serious efforts to give up smoking. Here, the engagement, knowledge, and support from all health professionals and the cardiac rehabilitation team is required. After information on the will- ingness and the stage of change of the patient to stop smoking, the method used to support the patients is described in this chapter, including indications for and use of pharmacotherapy.
Insight into smoking addiction, information, support, and understanding are important success factors for the cardiologist in helping the patient to stop smoking and prevent relapse.
Section V
Tobacco Addiction
