Study Suggests Smokers With PAD Need More Help With Cessation Strategies

October 10, 2018—The American Heart Association (AHA) announced the publication of a study on the smoking behavior of patients treated for peripheral artery disease (PAD). The study found that although many people with PAD smoke, few receive proven smoking cessation strategies from their doctors.

The study analyzed data from the PORTRAIT Registry and was published by Krishna K. Patel, MD, et al online in Journal of the American Heart Association.

According to the AHA, the study was composed of more than 1,200 patients who had gone to specialty vascular clinics to be treated for PAD. Because of claudication, patients were experiencing new or worsening leg pain or cramping when exercising. The study excluded patients without symptoms related to PAD, those whose disease was not severe enough to require a specialist, and those who received care at their primary care physicians’ offices.

The investigators reported:

• 37% of PAD patients were active smokers
• 16% received a referral to a smoking cessation counseling program
• 11% received drug treatment or nicotine replacement therapy
• 36% of PAD smokers who quit relapsed within 1 year
• 72% of active PAD smokers continued smoking after 1 year
• Patients’ chances of quitting were highest within the first 3 months after visiting their specialty health care providers

In the AHA announcement, Dr. Patel commented, “Smoking is the single most important risk factor for development and progression of PAD. More importantly, it is modifiable. Smoking cessation is the cornerstone for managing patients with this disease.”

Dr. Patel continued, “Many patients continue smoking or relapse after they attempt to quit. Doctors taking care of these patients need to be aware of this and provide consistent, ongoing cessation support to their smoking patients at every opportunity they get with them. Patients should not be afraid to reach out to their doctors, friends, family, and other cessation support services if they need additional help to quit or to prevent relapses.

“The next step is to identify the barriers in providing adequate smoking cessation support for PAD patients in order to identify what works and what could be improved upon,” advised Dr. Patel, who is a cardiology fellow at the University of Missouri-Kansas City, Saint Luke’s Mid America Heart Institute in Kansas City, Missouri.