<International Circulation>: From a cardiologist’s point of view， what are the implications of a patient’s smoking habit?
Dr Tonstad: I treat people who have risk factors for CVD and those that already have established CVD. For those with the risk factors， smoking affects their HDL-C， platelet aggregability and the risk of thrombosis. For example， if you are treating someone with a lipid disorder， on the one hand you give them a statin， but on the other hand you have to follow them for smoking cessation. For people with established CVD， we see that when they come in with ACS， on average 35 to 40% are smokers. About 80% quit with their ACS， but about half of those start again. This is our problem. When they come into the hospital， they are scared， they have the cardiologist telling them to quit and they do quit. They leave the hospital and go home and they experience stress， depression and anxiety then they start smoking one or two a day. Later on they are smoking 5 to 10 each day and it is imperative that we help them quit.
<International Circulation>: What advice and suggestions would you have for the current huge population of China that are smokers?
Dr Tonstad: I think first we need to start with Chinese health professionals. I would like to see physicians have a program that they could use or take the lead in quitting themselves as an example to their patients. It has always been shown that physicians who are themselves smokers do not do as great a job with their patient’s habit. In terms of the population as a whole， the financial cost of smoking can be prohibitory. From the health aspects， we are seeing more and more typically Western diseases in China - CVD and diabetes. Emphasis needs to be made that smoking directly causes CVD and most probably a cause of diabetes.
内容摘要：
患者戒烟需要医生的指导和监督
心脏病医生需要治疗具有CVD危险因素、以及已经罹患CVD的患者。对于前者，吸烟对HDL-C水平、血小板聚集性和血栓形成风险均有影响。例如脂代谢紊乱患者，除了他汀治疗，还必须要求其戒烟。对已患CVD者，35%~40%的ACS患者为吸烟者，由于自身对疾病的恐惧以及医生的指导和监督，80%的患者在治疗期间成功戒烟；遗憾的是，出院后近一半又开始复吸。因此，医生对患者戒烟进行长期监督是非常必要的。
中国医生需从自身做起
中国有庞大的吸烟人群，控烟工作必须从医务人员自身做起，为患者树立良好的榜样。一个吸烟的医生不可能成功地改变其患者的不良生活习惯。对于中国庞大的人口，吸烟的经济消耗是非常昂贵的。同时典型的“西方病”——CVD和糖尿病在中国越来越多。必须强调吸烟可直接导致CVD，并且也是糖尿病的可能致病因素。