European smokers who have a heart scare are no more likely to quit the habit today than their counterparts were almost a decade ago, despite high profile anti-smoking campaigns and doctors' advice to stop, a new study finds.
The research, presented Monday at Europe's largest medical conference, found that 52 percent of smokers who had a heart attack, bypass surgery or other serious heart scare were still smoking a year after their dramatic event. Experts said the findings indicate that smoking cessation efforts are failing many of the most vulnerable victims.
"We are disappointed because people are not stopping smoking, but how effectively are they advised to give up smoking?" said Dr. Jaakko Tuomilehto, a public health expert at the National Public Health Institute in Helsinki, Finland.
Smoking cessation programs don't exist in many cardiovascular clinics, and doctors have just been telling patients to stop smoking, which is not enough, said Tuomilehto, who was not involved with the research.
"It is an addictive state and these poor people are not receiving the right treatment. They would like to stop, but they need better help," he said.
Although there are no statistics robust enough for comparison with other regions, experts at the American Heart Association say the situation among U.S. smokers isn't much different.
Neither the government nor private insurance companies in the United States pay for drugs aimed at helping people quit smoking or smoking cessation programs, both of which help, said Dr. Rose Marie Robertson, chief science and medical officer at the American Heart Association.
All that is left is for the doctor to advise the patient to quit.
"If a doctor says it versus a doctor not saying it, it is better. You might double the quit rate, but it isn't enough," said Robertson, who also was not involved with the study.
The research, led by scientists at Erasmus University in Rotterdam, the Netherlands, involved 5,551 people in 15 European countries who were admitted to the hospital with a heart attack or who underwent either open heart surgery to bypass clogged arteries or balloon angioplasty, where a tube is threaded through the blood vessels to a blockage and a balloon is inflated to squash the plaque against the walls of the artery.
About a year and a half later, they were interviewed about their smoking and given a carbon monoxide breath test to verify their answers.
About 40 percent of the patients were smoking before they had their heart scare. About 52 percent of those people continued to smoke after they had recovered.
When a similar study was conducted in 1996, 40 percent of smokers continued the habit after their heart trouble. However, the difference found between these two studies was not statistically meaningful, so experts conclude that there has probably not been much change in the proportion of people quitting smoking after the illness.
The smoking continued despite 88 percent of them receiving personal advice to stop.
"Preventive cardiology regarding smoking cessation has not been improved since 1996," the study concluded. "A considerable and increasing proportion of patients with coronary heart disease continues smoking, despite advice from their physicians to quit," the study said, adding that there is a need for better smoking cessation programs.
Studies have shown that nicotine replacement therapy, drugs that help curb the craving, government policies such as smoking bans in public places, high taxes on tobacco and restrictions on cigarette advertising can substantially improve the chances of people kicking the habit.
The World Health Organization last year signed a global treaty aimed at curbing smoking and the millions of deaths it causes around the world. The treaty includes a ban on tobacco advertising and other restrictions, but countries are only now starting to implement it.
Doctors working with cancer patients have reported similarly disappointing rates of smoking cessation among their patients.
About 30 percent of European adults smoke. Rates are particularly high in Eastern Europe and rising sharply in the developing world. In the United States, about 23 percent of adults are smokers.
On the Net:
Congress of the European Society of Cardiology: http://www.escardio.org