Smoking cessation: evidence-based recommendations

Smoking is an important cause of morbidity and mortality, and is considered the most important preventable cause of disease and death in the developed world. It is a cause of cancer, heart disease, stroke, chronic obstructive pulmonary disease and pregnancy complications. Even though smoking is known as an important health hazard, tobacco use remains surprisingly high. In Portugal, 18% of the adult population smokes, and the prevalence of adolescent smoking has risen dramatically during the 90s. A significant percentage of actual smokers are willing to quit, creating a major responsibility for health care providers. Cardiologists bear a special responsibility, because there is good observational evidence that patients with coronary disease that quit smoking significantly lower their risk of recurrent ischemic events or death, and patients with peripheral vascular disease or stroke also get benefits, with better exercise tolerance, diminished rates of limb amputation, increased survival and less stroke recurrence. We wrote this paper to summarize the main recommendations on techniques of smoking cessation, based on evidence-based recommendations.