Quitting smoking nearly halves the risk of a heart attack - but cutting down on the habit sees little change, warns new research.
Researchers found that patients with stable coronary artery disease who quit smoking at any time after their diagnosis reduced their risk of a major cardiac event, including a heart attack, by almost 50%.
However, there was "minimal impact" on cardiovascular risk in patients who reduced their smoking habits.
French scientists assessed the impact of smoking on cardiovascular events in patients with coronary artery disease. The international CLARIFY registry included 32,378 patients with the condition.
The occurrence of a major adverse cardiovascular event (MACE), defined as cardiovascular death or myocardial infarction during the five-year follow-up period, was analyzed.
Patients were included in the study at an average of 6.5 years after their coronary artery disease diagnosis.
At the outset, 41.3% had never smoked, 46.2% were former smokers and 12.5% were current smokers.
Among the former smokers who smoked at the time of coronary artery disease diagnosis, 72.8% discontinued smoking within the following year, while only 27.2% quit in subsequent years.
Study author Dr. Jules Mesnier, of Hospital Bichat-Claude Bernard , Paris, said: “Interestingly, the first year after diagnosis was the crucial window for quitting.
"At the time of diagnosis, we should emphasize the importance of quitting and support patients in this challenge."
Patients who quit smoking after coronary artery disease diagnosis significantly improved their cardiovascular outcomes regardless of when they quit, with a 44% reduction in the risk of MACE.
However, among those who reduced the amount smoked, the risk of MACE was not significantly altered compared with smokers who did not change their smoking habits.
The risk of MACE after a coronary artery disease diagnosis increased by 8% for each additional year of active smoking, according to the findings.
Although smokers who quit smoking achieved a "rapid significant reduction" in risk of MACE compared to smokers, they never achieved the cardiovascular risk level of patients who never smoked - even after years of stubbing out the habit.
Dr. Mesnier said: “I like to tell my patients that it is never too soon or too late to stop smoking, though the sooner a patient stops, the better to lower cardiovascular risk.
"And it is not enough to reduce smoking.
"Short, clear messages are needed for smokers at every medical intervention highlighting the need to quit."
He added: "Telling patients they can cut their risk of a subsequent major event or death by half – as we have shown here – is a powerful message.”
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