Use of nicotine replacement therapy early in recovery post-acute myocardial infarction to aid smoking cessation

Patients admitted to hospital with a diagnosis of acute myocardial infarction (AMI) have high motivation to stop smoking. Nicotine replacement therapy (NRT) is known to be valuable in helping smokers quit although it is not commonly prescribed in patients in the acute phase following AMI.
Results from a full in-patient smoking cessation service were retrospectively analysed after the first 12 months, with particular reference to safety and efficacy in patients with AMI. Of 42 patients admitted with AMI who smoked and who were referred to the service, 32 (76%) received NRT with counselling as an in-patient, one as an out-patient and nine received counselling only. Assessment at four weeks showed 11 (26%) were still smoking, one (2%) had been lost to follow-up and 30 (71%) had successfully quit. Of these, six (20%) had not required NRT, one (3%) had received out-patient NRT and 23 (77%) had received in-patient NRT. There were no adverse outcomes in any patients.
This suggests an in-patient smoking cessation programme, including prescription of NRT in the first five days following presentation with AMI, is a safe and effective means of helping vulnerable people to give up smoking.