SMOKING CESSATION AFTER MYOCARDIAL INFARCTION

Introduction and objectives: Smoking is the main avoidable cardiovascular risk factor. Between patients with cardiovascular event, smoking cessation reduces the risk of new cardiovascular events. In Smoking Cessation Clinic of our health center, in 2014, an increasing number of smokers referenced after an acute myocardial infarction was noticed. The goal of this review is to understand why, when and how smoking cessation after myocardial infarction is relevant. Methods: Review of the bibliography published in MEDLINE, Cochrane Library and Nacional Guideline Clearinghouse at least 10 years with MeSH terms “smoking cessation” and “post myocardial infarction”. Results and discussion: Cardiac rehabilitation after a cardiac event is a Class I recommendation from European Society Cardiology and American Heart Association. Cardiac rehabilitation programmes are secondary prevention programmes where smoking cessation is an essential point. In Portugal these programs have small participation rate (4%), especially when compared to other countries in Europe (30%). Intensive smoking cessation therapy should be initiated even during hospital internment after myocardial infarction with follow-up for at least a month at home, which significantly increases smoking cessation rates. In cardiac patients there are concern about pharmacological smoking cessation treatment that should be taken into account. We conclude that the patient approach after acute myocardial infarction should be systematized with cardiac rehabilitation programmes in which intensive smoking cessation has a leading role. When these programmes fail, the family doctor has an important role in helping these patients in smoking cessation with brief intervention and, when opportunely, more intensive support.