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Dear Chapter member;

The Alabama Chapter of the American College of Cardiology in conjunction with the Alabama Department of Public Health are excited to provide you with the enclosed free materials to assist you in efforts to encourage smoking cessation among your patients.  Smoking cessation is a major focus of our Chapter in Alabama and these materials will hopefully provide you with a new mechanism for initiating conversations with your patients regarding cessation.

 In Alabama, 24.4 percent of high school students smoke, tobacco use kills 7,400 residents each year and costs the state in excess of $1.49 billion in health care bills.  Tobacco companies are targeting Alabama with $265 million in direct advertising money on a yearly basis.  Alabama’s prevention spending for smoking in 2007 is estimated at $682,000 which is clearly dwarfed by the efforts of tobacco companies.  Therefore the material the College is providing to your practice comes at a crucial time in our State’s health.

 Alabama residents can make a free phone call (1-800-Quit-Now) and receive free ongoing counseling and a free four-week supply of nicotine replacement therapy. If you refer your patients to the Quitline via a fax referral form found on the ADPH tobacco website, the Quitline will contact your patient and begin the counseling/quit process. If your patient consents, the Quitline will send you information on how he/she is doing in the quit process. In addition, the ADPH Tobacco Division offers free training to your staff in AARP – “Ask, Advise, Refer, Prescribe” in dealing with patients who use tobacco.

 Smoking is an independent major risk factor for atherosclerotic cardiovascular disease and stroke. The incidence of a myocardial infarction is increased six-fold in women and three-fold in men who smoke at least 20 cigarettes per day.  Cigarette smoking directly increases all-cause and cardiovascular mortality and carries an adjusted hazard ratio of 1.62 and 1.63 respectively.  Those who persisted in smoking cessation had no increased risk of death compared to nonsmokers.  Patients who continue to smoke in the presence of established CHD have an increased risk of reinfarction and sudden cardiac death.  Persistent smokers after coronary artery bypass surgery have a greater relative risk of all-cause mortality (relative risk 1.68), cardiac death (relative risk 1.75), and need for repeat revascularization (relative risk 1.41) compared to those who stopped smoking for at least one year.  After angioplasty, persistent smokers have a greater relative risk of death (1.76) and Q wave myocardial infarction (2.08) compared to nonsmokers.

 The College thanks you for your active and ongoing role in smoking cessation with patients in your practice and hope that these materials will offer you continued encouragement to continue to your efforts.

 

Sincerely,

 Paul B. Tabereaux, MD, MPH            
Chairman, Public Health Committee              
Alabama Chapter ACC


Michael B. Honan, MD
President, Alabama Chapter ACC

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