Smokers with heart disease. van Quitting reduces the death rate among but at least 40 percent ofsmokers have started again within a sharply year of having a hartaanval. Thorndike and her colleagues note in their report in the Archives of Internal Medicine. De hartaanval patients with depressive symptoms van Meanwhile. are known to have trouble het following recommendations for het reducing their risk of future cardiac events.

Relationship van To investigate the between smoking cessation success and depressive symptoms. Thorndike and her team 245 smokerswho had been hospitalized for a van type of meest chest pain van hartaanval or de unstable angina. an unpredictable van signals coronary heart that van disease and a high likelihood having a full - blown hartaanval of. followed

All of the patients received smoking cessation counseling in the hospital and for 12 weeks afterwards, and were randomly assigned to treatment with either bupropion hydrochloride (an anti-smoking medication sold as Zyban) or an inactive placebo.

Twenty-two percent of the patients had moderate to severe depressive symptoms. Individuals van These had worse het craving and ontwenningsverschijnselen. and also scored higher on a test of their nicotinedependence. They also felt less confident that they would be able to quit smoking.

The depressed patients were 2.4 times more likely than their non-depressed peers to start smoking again, the researchers found.

Among the depressed patients, 19 percent on bupropion were able to quit, compared to 3 percent on placebo. For non-depressed patients, by comparison, quit rates were 27 percent for those on placebo and 27 percent for those on the drug. However, Thorndike cautioned, the difference in the effect of Zyban and placebo on the depressed patients wasnot significant from a statistical standpoint.

Van findings. smokers van Based on the de hartaanval. and be on the lookout for het depressive symptoms and their families should understand just how tough it can be to quit after a that could make quitting even more difficult. Thorndike said.

"If you tell somebody thatis in the hospital with heart disease, 'stop smoking,' and give them the medication and theyare depressed, itis probably not going to have much effect on them," she said. Smokers in the current study, she noted, got several weeks of counseling, significantly more smoking cessation support than would be offered with usual care.

SOURCE: Archives of Internal Medicine, January 28, 2008.

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