Smoking? Current
smoking-currentNo one has reached this rule yetStopping is the highest-impact single change on the page
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Quitting smoking will do more for your heart than any medication on this page. Ask specifically about varenicline, or a nicotine patch combined with a lozenge.
Proven in trialsTrials counted real events, like heart attacks, strokes, or deaths, and this changed them.
Willpower alone succeeds perhaps 5% of the time; medication plus counselling multiplies that severalfold. Varenicline is the most effective single drug; combination nicotine replacement (a patch for the baseline plus a lozenge or gum for cravings) is close behind and available without a prescription. Free coaching is available at 1-800-QUIT-NOW. Excess risk of a heart attack starts falling within weeks and drops substantially over the first year.
ACC/AHA (US)
Being asked about tobacco at every visit, being firmly advised to quit, and behavioural support combined with medication are each Class 1, Level A, in the 2019 primary prevention guideline, the 2023 chronic coronary disease guideline and the 2024 peripheral artery disease guideline. Picking varenicline over the other medications is a weaker, Class 2b, recommendation.
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular D… · Recommendation behind this rule · class and level read from the guideline tables on 2026-09-30
Preferring varenicline over bupropion or nicotine replacement (chronic coronary disease)
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular D… · Graded separately within the same recommendation · class and level read from the guideline tables on 2026-09-30
Short-term nicotine e-cigarettes to aid quitting (chronic coronary disease; long-term safety unknown)
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular D… · Graded separately within the same recommendation · class and level read from the guideline tables on 2026-09-30
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease · Class 1 · Level A
“High calculated risk” — an illustrative profile, not a real user.
Cited by the recommendations above.
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Runs in lib/engine/preventionEssentials.ts as smoking-current.