Abstract
Smoking roughly doubles the risk of a cardiovascular (CV) event. Smokers usually abstain from smoking in the first days following a CV event, but after a longer period of time they relapse to smoking again very easily- after a year, one-half of them are smoking again.
Tobacco dependence is a chronic, relapsing disease. We should actively ask about smoking during every contact with every patient, but especially with patients after a CV event - even a small amount of tobacco smoke damages the blood vessels.
We should support non-smokers in abstinence, including exposure to passive smoking, prevent smoking relapses , offer assistance to smokers during a short intervention, or in cases of a lack of time, recommend the nearest intensive treatment option, mobile app or telephone quitline. Nicotine alone is not without cardiovascular effects (mainly cardiac action, sympathomimetic), but what is toxic is primarily the effect of substances produced by combustion, whether free radicals, carbon monoxide, polyhalogenated hydrocarbons or any of the several thousand other substances contained in tobacco smoke.
If the patient does not want or is unable to stop using nicotine, we can offer a less risky form without the substances contained in the smoke.