Evidence:

• The 1990 report of the U.S. Surgeon General examining the health benefits of smoking cessation identified five smoking cessation studies that examined the effect of different interventions on risk of death. No consistent benefit for this purpose was shown (7).
• The Lung Health Study was a randomized clinical trial of smoking cessation and inhaled ipratropium in smokers aged 35 to 60 years with asymptomatic mild to moderate airway obstruction. After 5 years, it showed that smoking cessation produced a reduced decline in FEV₁, and subgroup analysis shows reductions in fatal and nonfatal cardiovascular disease and coronary heart disease (15; 72). In a subsequent follow-up study at 14.5 years, all-cause mortality in the intervention group was 8.83 per 1000 person-years and 10.38 per 1000 person-years in the usual care group with a hazard ratio in the usual care group of 1.18 (CI, 1.02 to 1.37). The benefit was greatest for patients who quit smoking entirely (73).
• A randomized trial showed that an intensive smoking cessation intervention targeting smokers hospitalized with acute cardiovascular disease increased abstinence rates (33% intervention vs. 9% usual care) and over a 2-year follow-up period reduced hospitalizations and all-cause mortality (2.8% intervention vs. 12.0% usual care, absolute risk reduction 9.2%, NNT=11) (14).

Comments:

• None.