Abstract 19094: Vascular Medicine Based Smoking Cessation Program in an Outpatient Setting - Significant Reduction of Cardiovascular Risk Factors in Longterm Smokers by Multimodal Intervention
Smoking can be described as an addiction with profound cardiovascular implications. We propose a comprehensive intervention in a vascular based department including vascular diagnostic measures, behavioural as well as pharmacological treatment, which includes Varenicline, a partial nicotinic ACH-receptor agonist.
Objectives: The objectives of the present study are to describe core elements of this anti-smoker program and present prospective data concerning its reach and effectiveness.
Program Description: Core elements of the program include: global assessment of cardiovascular risk (ESC Euro score Germany), documentation of smoking status at baseline; inclusion of cessation intervention on patient care maps; individualized counselling by a psychiatrist; the appropriate and timely use of varenciline therapy; referral to outpatient cessation resources. Program reach and effectiveness were measured over a one-year period.
Results: (mean+SEM) Between May 2008 and November 2009, 64 smokers were identified (59% male, mean age 41+1.7 years) in public announced patient/ physician seminars on smoking cessation. At twelve-month follow-up, 82% were smoke-free. The CO level dropped from 44+2.4 ppm at baseline to 3+0.2 ppm after 12 month (p<0.05). In patients who quit smoking, there was a significant reduction in blood pressure (149/88+3/1 vs. 129/81+2/1 mmHg; p<0.01), total cholesterol (6.2+0.2 vs. 5.2+0.1 mmol/l; p<0.01) and no increase in body weight (81+2 vs. 82+2 kg). These changes led to a significant decrease in overall cardiovascular risk (score 4.2+1 vs. 0.8+0.2 after 12 month, p<0.01).
Conclusions: Abstinence in our program was high in comparison with other studies. The reduction in blood pressure and total cholesterol without an increase in body weight maybe assigned to lifestyle modification and resulted in a significant decrease the estimated 10-Year risk for a myocardial infarction. Our results demonstrate the promise of integrated smoking cessation therapy and indicate the need to pursue implementation and evaluation of this type of therapy on a larger scale and show the importance of doing this treatment in an internal medicine department. Untill end of October 2010 the 2-years-F/U will be done and data are available than.
- © 2010 by American Heart Association, Inc.