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Cardiovascular health

Facilitators and barriers to smoking cessation after myocardial infarction

02 May 2025
Clinical
02 May 2025
Volume 36 · Issue 5

Abstract

Smoking cessation is a key pillar of secondary prevention for patients who have experienced a cardiac event. This article summarises a literature review on smoking cessation after myocardial infarction, highlighting the implications for general practice nurses.

Smoking is a major risk factor for myocardial infarction, especially for patients who have already experienced a cardiac event. However, many patients who have experienced a myocardial infarction continue to smoke, suggesting that there are significant barriers to quitting. This article summarises the facilitators for, and barriers to, smoking cessation in this patient group, based on a systematic review of primary research. It also describes challenges and potential strategies for primary care nurses with patients who have experienced a myocardial infarction and may be struggling to quit smoking.

Amyocardial infarction – or heart attack – occurs when a disruption in blood supply causes the myocardial cells or heart muscle to die (Thygesen et al, 2018). Around 100 000 patients are admitted to hospital with myocardial infarction in the UK each year, of whom around 70% survive (British Heart Foundation, 2025).

Smoking tobacco has consistently been shown to increase the risk of myocardial infarction in the general population (Oliveira et al, 2007; Pedersen et al, 2016). The risk of death for people who continue to smoke after a myocardial infarction is nearly double that of those who quit (Critchley and Capewell, 2003; Yudi et al, 2017). Following smoking cessation, this risk rapidly declines; 5 years after quitting, people with a lighter smoking history can see their risk reduced to that of someone who has never smoked (Cho et al, 2024).

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Acute coronary syndrome
Myocardial infarction
Prevention
Smoking cessation