Quitting Smoking After Myocardial Infarction Improves Mental Health

Quitting Smoking After Heart Attack
Quitting Smoking After Heart Attack
Patients who quit smoking after an AMI may improve their long-term quality of life.

Quitting smoking after myocardial infarction (MI) can decrease chest pain and improve mental health in as little as one month and can reduce the chances of repeat cardiovascular problems in the long-term, according to researchers at the Washington University School of Medicine in St. Louis.

Smokers who experience an acute MI are offered counseling to help quit; however, many patients do not quit despite the known health risks. This may be because patients do not understand how quitting smoking can affect their day-to-day physical and mental health, Sharon Cresci, MD, and colleagues hypothesized in Circulation: Cardiovascular Quality and Outcomes.

To better understand health-related quality of life (QoL) benefits of quitting smoking after acute MI, they analyzed data from 4,000 patients enrolled in multiple trials that assessed recovery after MI. The analyses included patients with only acute MI and assessed QoL measures related to coronary artery disease. The patients were asked to fill out several questionnaires to assess their QoL in association with smoking status one year after an acute MI.

Overall, 46% of participants who smoked at the start of the trial quit in the year following acute MI. Former smokers and those patients who never smoked had levels of angina and angina-related QoL that were significantly better than current smokers. Recent quitters (defined as those who had quit in the previous year) did not have more angina than those who had never smoked.

There was a greater inverse association between smoking status and overall mental health than with overall physical health. Within 1 year, general mental health in recent quitters and former smokers was similar to that reported by patients who had never smoked. The patients who had quit before their acute MI had the same QoL domains as the patients who had never smoked.

Former smokers had similar results as those who had never smoked, suggesting that there could be a long-term benefit to quitting. The researchers note that, “patients categorized as recent quitters could have quit just over thirty days before their one-year follow-up interview after their acute MI and yet it could be that longer durations of smoking cessation are associated with better health-related QOL.”

Future long-term studies should examine whether those who quit smoking after an acute MI might see other benefits in their day-to-day life with increased abstinence, the researchers recommended. 

The current results may be helpful for patients concerned that quitting smoking may be harmful to mental health. The reduced risk for acute MI and a better health status should provide strong incentives for current smokers to quit.


  1. Buchanan DM, Arnold SV, Gosch KL, Jones PG et al. Association of smoking status with angina and health-related quality of life after acute myocardial infarction. Circulation. 2015; doi: 10.1161/circoutcomes.114.001545