Treatment of severe smoking after an acute myocardial infarction

Tobacco smoking is a chronic disease affecting one fifth of our population. Most smokers, however, are not conscious nor seek treatment for their problem. Some patients are able to reach abstinence by themselves but the majority need some kind of medical-psychological therapy. The best therapy to reach abstinence or improvement will depend on the stage of behavioral change. We present a case of extreme smoking (80 cigarettes a day) who presented a heart stroke and who was successfully treated with a stent. After he was discharged from hospital he was admitted to the smoking cessation program. He attended the program for 8 weeks and decreased his smoking by 94% at the end of the program. This case represents the clinical challenges and complexity of treatment for patients with a high degree of nicotine dependence in spite of life threatening consequences of tobacco smoking.