Tobacco. Its impact on vascular disease

The role of smoking in vascular disease is multifactorial and complex. Research continues to further elucidate the mechanisms involved and advance treatment options. What remains clear throughout is that smoking cessation has multiple health benefits. In a recent public health projection study of mortality and disability by cause, tobacco use was marked as the potentially largest health problem to be expected in the year 2020. Although smoking cessation is not simple, in the years spanning 1993 to September 1997, 1720 articles were published under the key words "smoking cessation," reflecting the difficulty of this endeavor and lack of a satisfying answer to this health problem. Nonetheless, approaches to patient smoking cessation should be attempted by all physicians. A protocol for physicians to assist patients with smoking cessation from the National Cancer Institute can serve as a general guide (Fig. 3). Some of the programs available to assist patients in smoking cessation are listed in Table 7.