Quitting Smoking: An Action That Does Not Bounce Back

Incorporating Disease-Oriented Smoking Cessation Education into the Care of Smokers with Peripheral Arterial Disease

“…In one study, when evaluating smoking in the sub-population of people with peripheral arterial disease, it was found that approximately 26% smoke, and as many as 79% have a smoking history, either current or former (Dunkley, et al, 2007). Smoking is a top modifiable risk factor contributing to PAD, second only to diabetes (Alexopoulos, Vlachopoulos, & Stefanadis, 2010;Conen et al, 2011;Hennrikus et al, 2010;Federman and Kravetz, 2007;Katsiki, Papadopoulou, Fachantidou, & Mikhailidis, 2013;Lu, Mackay, & Pell, 2014;Moyer, 2013;Muir, 2009;Paraskevas, Papas, Pavlidis, Bessias, & Andrikopoulos, 2008;Simmons, Steffen, & Sanders, 2012;Sontheimer, 2006;Steffen, Duprez, Boucher, Ershow, & Hirch, 2008;Verma, Prasad, Elkadi, & Chi, 2011;Watson, Watson, & Pater, 2006;Wiley, Kumar, & Vacek, 2012). Increased pack years of smoking increases the risks of developing PAD, and increases the morbidity and mortality of the diagnosis, demonstrating a dose-dependent relationship between the two (Au, Golledge, Walker, Haigh, & Nelson, 2013;Hankey, Norman, & Eikelboom, 2006;Katsiki et al, 2013;Lee et al, 2011;Paraskevas et al, 2008;Watson, Watson, & Pater, 2006).…”

“…Major pathophysiological factors involved in the peripheral arterial disease (PAD) include platelet activation and thrombosis, along with arterial stiffness. As lesions develop and increase in complexity, additional factors such as ulceration, rupture, or erosion also occur (Alexopoulos, Vlachopoulos, & Stefanadis, 2010;Watson, Watson, & Pater, 2006). Risk factors such as cigarette smoking contribute further to the process due to constriction and damage of arteries which potentiates endothelial dysfunction and alters lipoprotein metabolism, coagulation, and platelet function (Lee et al, 2011).…”

“…Significance. Peripheral arterial disease (PAD) is associated with a number of detrimental health effects such as amputation, heart attack, stroke, and death (Aiman et al, 2014;Alexopoulos, Vlachopoulos, & Stefanadis, 2010;Aronow, 2007a;Aronow, 2007b;Aronow, 2010;Haugen et al, 2007;Hennion & Siano, 2013;Hiatt & Krantz, 2006;Lee et al, 2011;Lovell et al, 2011;Moyer, 2013;Muir, 2009;Simmons, Steffen, & Sanders, 2012;Steffen et al, 2008;Verma et al, 2011;Watson, Watson, & Pater, 2006;Wiley, Kumar, & Vacek, 2012).…”

“…Poor utilization of smoking cessation interventions by the medical community has been identified in the literature, with recommendations to initiate education on the importance of smoking cessation education earlier, such as in undergraduate programs, and integrate it into the curriculum of medical schools (Aiman et al, 2014). Importantly, while the target is to quit smoking, it has been found that cutting down smoking may have beneficial effects (Alexopoulos, Vlachopoulos, & Stefanadis, 2010). Also, patients who attempt smoking cessation by switching to chewing tobacco were found to have higher rates of mortality than those who chose abstinence (Katsiki et al, 2013).…”