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Cessation of smoking

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Cessation of smoking

  1. 1. Cardiac Patient
  2. 2. The most important modifiable risk factor for cardiovascular disease
  3. 3. Tobacco Smoke causes harm 1.Contribute to a proinflammatory state 2.Damage endothelial surfaces 3.Induce endothelial dysfunction 4.Distort the lipid profile and oxidize lipoproteins 5.Facilitate platelet aggregation and activation 6.Elevate fibrinogen levels 7.Potentiate the development of atheroma 8.Contribute to plaque “instability” 9.Produce elevated levels of carboxyhemoglobin and impair oxygen transport
  4. 4. MORTALITY RISK REDUCTION IN CAD Smoking Cessation 36% Statin Therapy 29% β-Blocker Therapy 23% ACE-I Therapy 23% ASA Therapy 15%
  5. 5. UNIVERSITY OF OTTAWA HEART INSTITUTE STANDARD’ ORDERS FOR NICOTINE REPLACEMENT Standard Orders for Nicotine Replacement Therapy (NRT) 20 Cigarettes per day 21-mg NRT Patch +/× Short Acting NRT 30 Cigarettes per day 21 + 7-mg NRT Patches +/× Short Acting NRT 40 Cigarettes per day 2 × 21-mg NRT Patches +/− Short Acting NRT Standard Orders for Bupropion Day 1 to 3 150 mg qd Day 4 to Week 12 150 mg bid Standard Orders for Varenicline Day 1 to 3 0.5 mg qd Day 4 to 7 0.5 mg bid Week 2 to 12 0.5-1.0 mg bid (initial course may be repeated)
  6. 6. Have a nice time

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