Effect of Smoking Cessation on Mortality After Myocardial Infarction: Meta-analysis of Cohort Studies
Abstract
OBJECTIVE: To determine the effect of smoking cessation on mortality after myocardial infarction. DATA SOURCES: English- and non-English-language articles published from 1966 through 1996 retrieved using keyword searches of MEDLINE and EMBASE supplemented by letters to authors and searching bibliographies of reviews. STUDY SELECTION: Selection of relevant abstracts and articles was performed by 2 independent reviewers. Articles were chosen that reported the results of cohort studies examining mortality in patients who quit vs continued smoking after myocardial infarction. DATA EXTRACTION: Mortality data were extracted from the selected articles by 2 independent reviewers. DATA SYNTHESIS: Twelve studies were included containing data on 5878 patients. The studies took place in 6 countries between 1949 and 1988. Duration of follow-up ranged from 2 to 10 years. All studies showed a mortality benefit associated with smoking cessation. The combined odds ratio based on a random effects model for death after myocardial infarction in those who quit smoking was 0.54 (95% confidence interval, 0.46-0.62). Relative risk reductions across studies ranged from 15% to 61%. The number needed to quit smoking to save 1 life is 13 assuming a mortality rate of 20% in continuing smokers. The mortality benefit was consistent regardless of sex, duration of follow-up, study site, and time period. CONCLUSION: Results of several cohort studies suggest that smoking cessation after myocardial infarction is associated with a significant decrease in mortality.
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Many epidemiological studies have reported that regardless of age and gender, the risk of recurrence of cardiovascular events decreases by approximately half after the first year of smoking cessation and continues to decrease thereafter.
“Many epidemiological studies have reported that regardless of age and gender, the risk of recurrence of cardiovascular events decreases by approximately half after the first year of smoking cessation and continue to decrease thereafter.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [781]
In patients with CAD who continue to smoke, the risk of recurrence of cardiovascular events is higher than that observed in nonsmokers.
“In patients with CAD who continue to smoke, the risk of recurrence of cardiovascular events is higher than that observed in nonsmokers.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [781]
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- Authors
- Wilson, K., Gibson, N., Willan, A., & Cook, D.
- Affiliations
- McMaster University (CA)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2000-04-10
- Volume
- 160
- Issue
- 7
- Pages
- 939
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1985628753
- Cited by
- 415
- References
- 43
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 8 · 2023: 12 · 2022: 13 · 2021: 13 · 2020: 11 · 2019: 10 · 2018: 12 · 2017: 14 · 2016: 12 · 2015: 31 · 2014: 16 · 2013: 27 · 2012: 23
- FWCI
- 9.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- smoking cessation, myocardial infarction, mortality, cardiovascular risk factors, tobacco use, post-infarction survival
- MeSH terms
- Age Factors, Female, Follow-Up Studies, Humans, Male, Myocardial Infarction, Research Design, Risk, Global Health, Confounding Factors, Epidemiologic, Odds Ratio, Smoking Cessation
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