Quitting Smoking After Heart Attack Reduces Chest Pain

Smokers who quit within a year after a heart attack had similar levels of chest pain and mental health as those who never smoked, and better general mental health than those who continued to smoke, according to a new study.

“This information could help alleviate the fears of those concerned that smoking cessation may not really make a difference in how they feel or could have detrimental effects on their mental health,” says lead study author Donna Buchanan, PhD, a researcher and outcomes manager with Saint Luke’s Mid America Heart Institute in Kansas City, Mo.

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“In addition to counseling patients who have had a heart attack about how smoking cessation reduces the risk of death and having another heart attack, health care providers can share these findings showing that, within just 1 year, smoking cessation was associated with less chest pain and better mental health, which are health status factors that are often equally or more important to patients than how long they live,” she says.

Buchanan and her colleagues evaluated about 4,000 adults in two US multi-center heart attack patient registries for smoking, chest pain, and health-related quality of life measures at admission, and at 1 month, 6 months, and 12 months after their heart attacks.

Of these patients, 29% had never smoked, 34% were former smokers who quit before their heart attacks, and 37% were active smokers. Of the active smokers, 46% quit smoking within the first year after their heart attacks.

Those who had quit smoking before their heart attack had a similar health status to those who had never smoked, while smokers who quit within a year after their heart attack had intermediate levels of chest pain and mental health similar to those who had never smoked.

Those who continued to smoke after a heart attack had the worst health status. At the 1-year follow-up, persistent smokers were 1.5 times more likely to have chest pain compared to those who had never smoked. Their assessment scores were also 3.5 points lower for quality of life related to chest pain, 1.6 points lower for general physical functioning, and 2.3 points lower for general mental health.

“One of the study’s limitations is that we did not assess the number of years or intensity of smoking,” says Buchanan, who is also an associate professor at the University of Missouri-Kansas City’s School of Medicine. Thus, the authors cannot comment on whether these factors are associated with differences in health status.

“It would be interesting to conduct future research where patients are followed for a longer period of time beyond 1 year after their heart attack to determine if increased time of abstinence is associated with additional areas of health status benefits,” Buchanan says.

—Colleen Mullarkey


Buchanan DM, Arnold SV, Gosch KL, Jones PG, Longmore LS, Spertus JA, et al. Association of smoking status with angina and health-related quality of life after acute myocardial infarction. Circ Cardiovasc Qual Outcomes. August 25, 2015. [Epub ahead of print].