Imagine what it would be like if every time you got on an airplane you were struck with the realisation that three fully loaded jumbo jets crashed daily, killing all aboard. Needless to say, there would be much more fear of flying. Yet in America, the equivalent of three jumbo jetloads of people every day (390,000) die directly as a result of cigarette smoking.
If you’re a smoker, or even a former smoker, you and I provide more statistics. Cigarette smoking is one of the Big Three risk factors for a heart attack, along with high blood pressure and cholesterol. I know in my own case that it was the real reason for my heart attack at age 35.
As I’ve already told you, I have a family history of heart disease. Yet my Dad didn’t have his attack until he was 57. The big difference was that he didn’t smoke. By the time I entered college, I was a confirmed smoker, and soon I was smoking two packs a day. And I do mean I smoked them all, I didn’t just light them and leave them to smoulder in an ashtray. I sucked that smoke down to my toes, 40 times a day, every day.
Of course we’ve all heard over and over that smoking is bad and that everyone should quit. But this takes on a whole new meaning for those recovering from a heart attack or bypass, or for those who have confirmed heart disease. It’s now a matter of secondary prevention, making sure that we don’t have another attack or need another bypass.
If you’ve already quit, congratulations. I know it can be one of the most difficult things in life to do. If you haven’t quit yet, don’t feel too ashamed. You’re in good company. It’s a sad but true fact that fully half of all of us who have a heart attack continue to smoke. Anywhere between 40 and 75 per cent of patients will go back to smoking after a bypass, even if they quit for a while after getting back from the hospital.
Those most likely to quit are those who have a really close call, a really major heart attack. Then there are those who realise that this is a truly serious matter, and that quitting can be a matter of life or death.
I must admit that I continued to smoke after my heart attack and first bypass. First there was the matter of my mental attitude. I was mad at the world and furious with my own body for failing me. I’d be damned if I was going to give up all my pleasures. And, down deep inside, I didn’t admit that the disease was bigger, “badder” and meaner than I was.
To make matters worse, my cardiologist at the time did little to discourage my habit. I had cut down to about eight cigarettes daily, and he asked whether those helped me to relax. I said they did, and he reassured me that the relaxation I derived probably balanced out the damage done. So I kept on puffing, staying in a state of perpetual withdrawal since I really wanted to smoke more than that. But the doctor said it was OK, and that was OK with me. Remember, however, that this was in 1978. We’ve learned a lot since then, and I don’t imagine one could find a single physician today who would counsel heart patients that it was acceptable to smoke even a few cigarettes daily.
Unfortunately, while those doctors might intellectually recognise the dangers of smoking, especially for heart patients, they don’t always do everything necessary to help those patients quit. Too frequently, doctors mention it only in passing, but don’t press the point. Yet those who do quit most often are those who have been given very strong encouragement from their doctors. Some physicians actually refuse to continue to treat patients who won’t try to quit. But most take a far more passive role, at most giving out little brochures pointing to the dangers.
Why is quitting such an important step? By doing so, you cut the risk of sudden cardiac death in half in just two days. Immediately following a heart attack, and for the ensuing weeks, the risk of another heart attack, and potentially a fatal one, is highest. You can cut that risk in half by quitting now.
Moreover, you’ll halve the rate of all morbidity and mortality that may occur after heart attack. This is true no matter how severe that heart attack might have been.
The converse is just as true. You cut your chances of survival by 50 per cent if you continue to smoke.
And it’s never too late. Many patients erroneously believe that the damage is done, and that there’s no point in quitting after the heart attack. Kind of like closing the barn door after the horse has run away, they feel. But it’s not true. Those statistics above apply to everyone, young or old.
The importance of quitting applies to women as well. For women, nothing raises the risk of heart attack more than smoking. Want proof? Researchers at the University of Pennsylvania and Boston University schools of medicine studied 555 women who had survived a first heart attack. There was a distinct increase in risk of having a second heart attack as the number of cigarettes went up, even after considering the effects of other risk factors such as blood pressure and cholesterol.
Unlike men, women are at risk of a heart attack when they smoke even if their coronary arteries aren’t all that clogged. British researchers have found that women smokers are twice as likely to die from a heart attack, regardless of the state of their arteries. For women, smoking may have a more immediate influence, involving the clotting and clot break-down processes rather than just contributing to the long-term atherosclerotic process as with men.
On the plus side, women can reduce their risk quickly when they give up the cigarettes. On the other hand, they often find that even more difficult to do than men. Regardless of difficulty, however, it’s worth every bit of effort.
After a heart attack, both men and women hate the notion of having to give up all their pleasures. Smoking appears to provide the comfort and solace not found elsewhere. This is particularly true for those who become depressed after their heart attack. Here we have a vicious circle. Depressed persons are more likely to smoke cigarettes, yet smoking contributes to guilt and further depression, and the act of quitting can lead to depression itself.
For some heart patients, there seems to be so much to be done at once. You want to quit smoking, but you’re also trying to control your weight, and you’re avoiding fatty foods to keep cholesterol levels down. Moreover, the chance of failure looms, and the last thing you want is something else to fail at.
If anything, the mind rationalises, this is the time you really need a friend, and that cigarette is a friend indeed. After all, it was the cigarette that was there for every time of trouble and for every time of triumph for just about as long as you can remember. Is it even possible to think about living life without the cigarette?
Yes, it is possible. Although that cigarette has been your “friend”, it is also your deadly enemy. Compare it with the black widow spider that eats its partner after mating. You lived for quite a few years before you began to smoke and you’ll live a lot more years if you stop. It’s tough, yes, but millions of people have done it, and you can too.
Cardio & Blood/ Cholesterol