Intended for healthcare professionals

Research Article

Long term effect on mortality of stopping smoking after unstable angina and myocardial infarction.

Br Med J (Clin Res Ed) 1983; 287 doi: (Published 30 July 1983) Cite this as: Br Med J (Clin Res Ed) 1983;287:324
  1. L E Daly,
  2. R Mulcahy,
  3. I M Graham,
  4. N Hickey


    Subjects who stop smoking cigarettes after myocardial infarction have an improved rate of survival compared with those who continue, but to date it was not known whether the benefit persisted for more than six years. A total of 498 men aged under 60 years who had survived a first episode of unstable angina or myocardial infarction by two years were followed up by life table methods for a further 13 years. Mortality in those who continued to smoke was significantly higher (82.1%) than in those who stopped smoking (36.9%). These differences increased with time. Mortality in those who were non-smokers initially and who continued not to smoke was intermediate (62.1%). The adverse effect of continued smoking was most pronounced in those with unstable angina. Continuing to smoke increased the rate of sudden death to a greater degree in those with less severe initial attacks, while the effect of smoking on fatal reinfarctions was most apparent in those with a more complicated presentation. These findings suggest that stopping cigarette smoking is the most effective single action in the management of patients with coronary heart disease.