a cigarette butt with a skull face at the end with embers

Smoking Cessation and Heart Failure

It is no surprise that cigarette smoking is a major preventable cause of death in the world. Smoking leads to the buildup of plaque in the arteries, leading to heart disease, heart failure, and death.


Despite these facts, 16% of people with heart failure continue to smoke. This increases the risk of hospitalization by approximately 45% and death by 40%.1 However, that information is not enough to motivate people to discontinue their vice. Most of us know at least one person who has lived a long and healthy life despite heavy tobacco use. These people, however, should be regarded as exceptions - not the norm. While some people can quit smoking cold-turkey, others may benefit from pharmacological assistance.

Determining readiness to quit

Before starting the journey to quit smoking once and for all, it is important to sit down and be honest with yourself: am I ready to quit? The process of behaviour change falls along this spectrum:2

  1. Pre-contemplation: not ready to consider quitting
  2. Contemplation: considering quitting
  3. Preparation: currently planning on quitting
  4. Action: already actively involved in quitting
  5. Maintenance: no longer smoking

Those in the preparation stage may benefit from setting a quit date within 2-4 weeks.

Nicotine withdrawal

The number one reason why people fail to quit smoking is because of nicotine withdrawal symptoms. Usually these symptoms reach their height in the first 3 days of quitting, and get better over the next month. Symptoms of nicotine withdrawal include:

  • Weight gain due to increased appetite
  • Moodiness or depression
  • Troubles sleeping
  • Irritability
  • Agitation
  • Troubles concentrating

For people who find these symptoms to be intolerable, nicotine replacement products can help.

Nicotine replacement products

Nicotine replacement products work by delivering nicotine, helping to alleviate withdrawal symptoms. There are various formulations available, and most are available over-the-counter without the need for a prescription. One formulation is not necessarily better than the other; the type of product should be picked based on preference. The most common formulations include:

  • Patch: the patch must be applied to a clean, hairless area of the skin once daily in the morning only after the old patch is removed. For that, it is convenient; however, it may not be the best option for those with skin conditions such as eczema due to potential skin irritation.
  • Gum: to get the benefit of the gum, it is recommended to chew the gum a few times and then “park” it on the side of the mouth for 1 minute to allow the nicotine to be absorbed. This may be a good option for people who enjoy chewing gum; however, it can cause throat irritation and a cough in some people.
  • Lozenge: like the gum, it is recommended to suck the lozenge and then hold it to the side of the mouth. This formulation may cause heartburn.
  • Inhaler: people who miss the hand-to-mouth motion of smoking may do well with this formulation. Throat irritation and cough are common side effects.

These products can double your success of quitting smoking. Smoking cessation is the single most beneficial habit one can implement for heart health; with the right tools and support, it can be accomplished.

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