Tobacco use is a major risk factor for heart disease, significantly impacting morbidity and mortality.
Screening for tobacco use in patients with suspected heart disease is essential for identifying risk, guiding treatment, and enabling early intervention.
Key components include recording smoking history, assessing the type and frequency of use, and determining readiness to quit.
Tools like the Fagerström Test for Nicotine Dependence can aid in evaluating nicotine dependence levels.
Integrating tobacco screening into cardiovascular care helps modify a major risk factor, supporting both prevention and improved patient outcomes.
A streamlined approach in clinical settings can enhance care quality and support cessation.
E-cigarettes and smokeless tobacco are significant concerns in cardiovascular care.
While marketed as alternatives to smoking, both contain nicotine and harmful substances that increase heart disease risk.
Screening for these types of tobacco use in patients with suspected heart disease is crucial, as they contribute to hypertension and vascular damage similar to traditional cigarettes.
Identifying e-cigarette and smokeless tobacco use allows healthcare providers to address all forms of nicotine dependence and provide comprehensive cessation support, which is essential for improving cardiovascular outcomes.
E-cigarette/Vape/Chargeable Cigarette
Smokeless Tobacco
E-cigarettes are often marketed as safer alternatives to traditional cigarettes, but they have notable downsides, particularly regarding cardiovascular and respiratory health.
Key concerns include:
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Nicotine Addiction:
E-cigarettes contain high levels of nicotine, which is addictive and can lead to long-term dependence.
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Cardiovascular Risks:
Nicotine and other chemicals in e-cigarettes can raise blood pressure and increase the risk of heart disease.
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Respiratory Issues:
The inhaled aerosols may cause lung irritation, inflammation, and respiratory conditions, especially with prolonged use.
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Unknown Long-Term Effects:
Since e-cigarettes are relatively new, their long-term health impacts are still unknown, raising concerns about unforeseen risks.
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Youth Appeal:
E-cigarettes are often flavored, making them particularly appealing to young people, leading to early nicotine dependence and potential health consequences.
Drugs That Aid Smoking Cessation:
Nicotine Patches/Gums/Lozenges:
They play a significant role in curbing tobacco use and aid in the gradual cessation of smoking.
Varenicline and Bupropion:
Varenicline is a prescription medication that aids smoking cessation by reducing cravings and blocking nicotine’s rewarding effects. It works as a partial agonist at nicotine receptors, helping to ease withdrawal symptoms while reducing satisfaction from smoking. Clinical studies show that varenicline significantly improves quit rates, making it a valuable option in comprehensive smoking cessation programs.
Bupropion is an antidepressant also used to help people quit smoking. It works by reducing cravings and withdrawal symptoms, acting on brain chemicals involved in addiction. Studies show that bupropion can effectively increase quit rates, making it a helpful option for smoking cessation, especially for those with a history of depression.
Quitting Success:
The annual smoking quit rate is 10 percent and less.
Routine screening for smoking status by clinicians and giving a clear message that “quitting smoking is the best thing you can do for your heart” will reinforce quitting behaviour among patients and help reduce CV risk.
Dr. S. Booma
Associate Consultant Cardiologist,
Kauvery Hospital, Chennai
