Disclosures: The authors report no relevant financial disclosures.
June 09, 2021
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Many adults with CVD continue to smoke despite risks

Disclosures: The authors report no relevant financial disclosures.
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More than one-fourth of adults with CVD use tobacco products and few of them quit over 5 years, researchers reported.

“At the conclusion of our study, we were surprised that so few cigarette users with cardiovascular disease were part of a formal smoking-cessation program. It was also concerning that despite the well-documented benefits of stopping tobacco use after a CVD diagnosis, few people had stopped smoking over the course of the 5-year study,” Cristian Zamora, MD, FAHA, a third-year internal medicine resident at Jacobi Medical Center at Albert Einstein College of Medicine, said in a press release.

More than one-fourth of adults with CVD use tobacco products and few of them quit over 5 years. Data were derived from Reynolds LM, et al. J Am Heart Assoc. 2021;doi:10.1161/JAHA.121.021118.

The researchers analyzed 2,615 participants aged 18 years or older from the PATH study (48% women) with self-reported CVD histories and compared tobacco use rates from 2013 to 2018.

According to the researchers, 95.9% of participants said they knew that smoking caused heart disease, whereas 40.2% said they believed that e-cigarettes were less harmful than combustible cigarettes.

Among the 2,615 participants in 2013-2014, 28.9% reported current tobacco product use (95% CI, 26.6-31.3), equating to 6.2 million (95% CI, 5.7-6.7) U.S. adults.

The most commonly used products among current tobacco users with prevalent CVD were:

  • cigarettes (82.8%);
  • cigars (23.7%); and
  • e-cigarettes (23.3%).

According to the researchers, current usage of any tobacco product among adult participants with CVD was associated with younger age (OR = 0.7; 95% CI, 0.5-0.9). In the cohort, men were more likely than women to use any tobacco product (OR = 2.2; 95% CI, 1.7-2.8), especially cigars (OR = 3.4; 95% CI, 2.4-4.8), but women were more likely than men to use e-cigarettes (OR = 0.7; 95% CI, 0.5-0.9).

Compared with those at 200% or higher above the poverty line, those below it (OR = 1.9; 95% CI, 1.3-2.6) and those at or near it (OR = 1.4; 95% CI, 1.1-1.8) were more likely to use any tobacco product, according to the researchers.

From 2013 to 2018, among cigarette smokers in the cohort, cigarette use declined less than 5% while e-cigarette use rose 0.5%, the researchers wrote, noting only about 10% were in smoking-cessation programs.

“Our findings support the need for a stronger commitment from a multidisciplinary team, including the primary care professional, social worker, psychologist and cardiologist, to provide smoking-cessation therapies and counseling to people with cardiovascular disease. Health care reforms and public health policies should improve the availability of tobacco-cessation programs and tools for high-risk populations,” Zamora said in the release.