Seeing through the smoke: The impacts of quitting and quitting strategies in 3 populations

The Bottom Line

  • Cigarette smoking can lead to illness and death. 
  • Quitting smoking can decrease the risk of dying and future cardiovascular events in people living with coronary heart disease, improve symptoms and quality of life in people living with chronic obstructive pulmonary disease, and reduce the risk of complications following surgery. 
  • Combining behavioral supports and drug treatments appears to be an especially effective quit strategy.
  • Those interested in quitting should collaborate on developing an effective quit plan with their healthcare team.   

Each year, tobacco use—most commonly in the form of cigarette smoking—results in significant illness and death around the globe (1). For example, smoking increases the risk of developing heart disease, chronic obstructive pulmonary disease (COPD), and complications following surgery (1-4). Additionally, those who live with long-term health conditions and continue to smoke are vulnerable to even worse health outcomes (5). While it’s best to never pick up smoking, quitting, if you do smoke, is incredibly important!


That said, quitting isn’t easy, and many people may need help getting motivated to quit or support along their quit journey. This is why it’s good to remind ourselves of a few of the many benefits of quitting and some useful tools for us to lean on, especially as we set new health goals for the year and make plans for achieving them. Let’s breakdown the pros of quitting and supportive strategies available by looking at a few different populations of people who may smoke (5-7). Click on the links below to learn more.   


1. People living with coronary heart disease  

Heart disease resulting from tobacco use is responsible for about two million deaths around the world every year (8). Research shows that quitting smoking can help people living with coronary heart disease decrease their risk of dying from cardiovascular disease and experiencing cardiovascular events like non‐fatal heart attacks and non‐fatal strokes. Quitting also has the potential to boost quality of life. Further research is needed to enhance our confidence in the evidence of certain findings (5).      


2. People living with chronic obstructive pulmonary disease   

Smoking is one of the leading causes of COPD. In fact, it’s responsible for more than 70% of COPD cases within high-income countries, like Canada and the United States (3). Quitting smoking can improve symptoms and quality of life for people living with COPD, as well as lengthen life span (3;6;9). In terms of what works to help this population quit, research shows that various behavioral treatments and drug treatments, such as cognitive behavioral therapy, nicotine replacement therapy, and varenicline may be effective. What’s more, combining more than one strategy or treatment appears to be most effective (6).           

3. People scheduled for surgery  

People who smoke and undergo surgery are at an increased risk of post-surgery complications like infections, pneumonia, and additional breathing problems (4;10;11). Factors such as a weakened immune system and damaged lung lining contribute to these risks (10;11). Research shows that intensive behavioural support (often alongside the offer of medication) can help people who smoke quit prior to their surgery and remain smoke free up to one year later (7). Additionally, those who quit can increase their likelihood of having a successful surgery and faster recovery, while also decreasing their risk of complications following surgery (7;12). 


Quitting smoking is beneficial for anyone who smokes. If you smoke and need support in developing a quit plan that is tailored to you and can increase your chances of success, reach out to your healthcare team.   


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References

  1. World Health Organization. Tobacco. [Internet] 2023. [cited November 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco
  2. World Health Organization. Cardiovascular diseases (CVDs). [Internet] 2021. [cited November 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)  
  3. World Health Organization. Chronic obstructive pulmonary disease (COPD). [Internet] 2024. [cited November 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)  
  4. Bluman LG, Mosca L, Newman N et al. Preoperative smoking habits and postoperative pulmonary complications. Chest. 1998; 113:883-889.
  5. Wu AD, Lindson N, Hartmann-Boyce J, et al. Smoking cessation for secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2022; 8:CD014936. doi: 10.1002/14651858.CD014936.pub2. 
  6. Wei X, Guo K, Shang X, et al. Effects of different interventions on smoking cessation in chronic obstructive pulmonary disease patients: A systematic review and network meta-analysis. Int J Nurse Stud. 2022; 136:104362. doi: 10.1016/j.ijnurstu.2022.104362. 
  7. Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014; 3:CD002294.
  8. World Health Organization. Tobacco responsible for 20% of deaths from coronary heart disease. [Internet] 2020. [cited November 2023]. Available from: https://www.who.int/news/item/22-09-2020-tobacco-responsible-for-20-of-deaths-from-coronary-heart-disease 
  9. Abu Hassan H, Abd Aziz N, Hassan Y, et al. Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients? Int J Chron Obstruct Pulmon Dis Pulmon Dis. 2014; 9:493-498. doi: 10.2147/COPD.S56637. 
  10. Lourenco RV, Klimek MF, Borowski CJ. Deposition and clearance of two micron particles in the trachiobronchial tree of normal subjects – Smokers and non-smokers. JCI. 1971; 50:1411-20.  
  11. Sorensen LT. Wound healing and infection in surgery: The pathophysiological impact of smoking, smoking cessation and nicotine replacement therapy: A systematic review. Annals of Surgery. 2012; 255:1069-1079. 
  12. Fiddes RA, McCaffrey N. Preoperative smoking-cessation interventions to prevent postoperative complications: A quality assessment and overview of systematic review evidence. Anesth Analg. 2024. doi: 10.1213/ANE.0000000000007187. 

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