A recent French study suggests smoking cessation in patients with peripheral arterial disease (PAD) is achievable with intensive and appropriate management, with the prescription of a pharmacologic smoking cessation treatment and follow-up with smoking cessation services both identified as important elements that increase abstinence.
The research team behind the findings—led by Anne-Laurence Le Faou, MD, a public health expert at Université Paris Cité in Paris, France—probed data on 3,656 smokers with PAD who were followed in smoking cessation services. They found that 48% smoked more than 20 cigarettes per day, with 65% being “high-nicotine dependent”—among whom 46% reached one month of abstinence. Factors favoring not smoking included equal-to-or-greater-than one previous quit attempt, high confidence in quitting, increasing number of follow-up visits, and taking smoking cessation medications, Le Faou and colleagues report.
The study, which was published in the August edition of the Journal of Vascular Surgery (JVS), comes as the SVS Vascular Quality Initiative (VQI) continues a monthly webinar series on smoking cessation throughout 2025. The educational content consists of a 12-month program—the audience for which includes physicians, advanced practice providers (APPs), nurses and patients—and draws on insights gained by Betsy Wymer, DNP, SVS director of quality, during her training for tobacco specialist certification.
The data in the French study were drawn from a national, multicenter database of 266 nationwide institutions—mostly hospital-based—and cover an 18-year time period. It included current smokers over the age of 18 who reported smoking “every day” or “some days” at the time of their first visit who had PAD and completed at least 28 days of follow-up in a smoking cessation service. Among the near quarter million patients recorded in the national CDTnet database, 12,655 had PAD and 6,984 (55%) visited a smoking cessation service at least once after their first visit. Among retained smokers, 29% were followed for at least 28 days.
Le Faou et al found that most smokers were prescribed a smoking cessation pharmacologic treatment (87%), and more than one-half benefited from two to three follow-up visits and 45% from more than four visits after the first contact. Some 43% of women and 47% of men quit smoking, the researchers discovered. Those who achieved abstinence were most often older smokers (≥65 years; 50%), had a vocational school diploma (49%) or higher education (49%), were retired (52%), referred by primary care professionals (50%), and had high confidence to quit (52%). “The percentage of abstinent patients increased gradually with the number of follow-up visits, so that among those who benefited from seven or more follow-up visits, 74% succeeded in quitting smoking,” the research team notes.
The smokers with PAD with the lowest abstinence rates were female smokers (43%); smokers between 35 and 54 years old; smokers without diplomas (42%); those who were unemployed (35%); smokers with comorbidities, especially diabetes (43%), myocardial infarction and angina (43%), chronic bronchitis and/or chronic obstructive pulmonary disease (COPD) (43%); and the smokers with psychiatric disorders (42%).
Factors negatively associated with quitting were being unemployed, having diabetes, taking antidepressants, presenting with moderate and high nicotine dependence, having consumed cannabis in the previous 30 days, and being prescribed an oral nicotine form solely at the first visit. The findings show that smoking cessation pharmacologic treatment and psychosocial support “are underutilized, hampering the chances of quitting in smokers with PAD,” Le Faou et al comment. “For hospitalized patients, an individual approach with several visits, starting during hospitalization with motivational interviewing techniques, explanations on tobacco addiction, and personalized treatment with subsequent tailored follow-up visits after hospital discharge would be helpful to quit smoking,” they add.
