18% of people with incident heart disease smoke tobacco and less than half manage to stop. Clinicians intervene actively to support cessation for a small minority when we know that continued smoking is a matter of addiction, not a choice, for most of this group. This BHF-funded doctoral proposal aims to address this by:
- Updating the Cochrane review of the effect of cessation on the recurrence of cardiovascular disease (CVD) in those with incident CVD, for the first time, including the risk of recurrent stroke in those with incident stroke;
- Producing novel estimates of the association of smoking with CVD recurrence, using data from a large primary care record database and incorporating novel methods to assess the causal effect of active support for cessation on recurrence; and
- Creating a way to reframe the management of offering smoking cessation support, to trigger doctors to view smoking as an addiction to be treated and not a matter of choice. This reframing will then be tested in online experiments to produce early evidence that we can change the way doctors treat people who smoke by providing active support for cessation. The student will work with patients with CVD who smoke to incorporate the outcomes that matter to them.
