Cigarette smoking is an important risk factor for cardiovascular disease, yet few studies have looked at smoking prevalence among people previously diagnosed with cardiovascular disease.

In a study published online on June 9 in the Journal of the American Heart Association, Carlos Jose Rodriguez M.D., M.P.H., Cristian Zamora, M.D., and colleagues analyzed data from 2,615 participants 18 years old and over who were enrolled in the nationally representative Population Assessment of Tobacco and Health (PATH) Study between 2013 and 2018 and self-identified as having cardiovascular disease. The researchers found that 28 percent of participants were smoking cigarettes in 2013-2014; and despite the well-documented benefits of stopping smoking after being diagnosed with cardiovascular disease, one in five adults with heart disease was still using cigarettes 4 to 5 years later. In addition, only about 10 percent of current cigarette users with cardiovascular disease were taking part in a formal smoking cessation program, and fewer than one-fourth of those surveyed had quit smoking over a four-year period.

The study also saw a rising use of e-cigarettes among people with cardiovascular disease but this did not appear to influence tobacco cessation and instead promoted dual-use of both combustible cigarettes and e-cigarettes.  A clear takeaway from the study: further efforts are needed to enroll more people with cardiovascular disease in formal tobacco-cessation programs and to make these programs accessible and affordable especially for high-risk individuals. 

Dr. Rodriguez is a professor of medicine and of epidemiology & population health and director of Clinical Cardiology Research and Cardiovascular Epidemiology at Einstein. Corresponding author, Dr. Zamora, is an internal medicine resident at Jacobi Medical Center at Einstein.