MUNICH, Germany (AP) _ More than half of European smokers who suffer a heart attack, bypass surgery or other serious heart problem are still smoking a year later, despite anti-smoking campaigns and doctors' advice to stop, a new study found.
Experts said the findings, presented Monday at Europe's largest medical conference, indicate that smoking cessation efforts are failing many of the most vulnerable victims.
``We are disappointed because people are not stopping smoking, but how effectively are they advised to give up smoking?'' said Dr. Jaakko Tuomilehto, a public health expert at the National Public Health Institute in Helsinki, Finland.
Programs to help smokers kick the habit don't exist in many cardiovascular clinics, and doctors have just been telling patients to stop smoking, which is not enough, said Tuomilehto, who was not involved with the research.
``It is an addictive state, and these poor people are not receiving the right treatment. They would like to stop, but they need better help,'' he said.
Experts at the American Heart Association say the situation among U.S. smokers isn't much different.
Neither the government nor health insurance companies in the United States pay for drugs or programs aimed at helping people quit smoking, both of which help, said Dr. Rose Marie Robertson, chief science and medical officer at the American Heart Association.
All that is left is for doctors to advise their patients to quit.
``If a doctor says it, versus a doctor not saying it, it is better. You might double the quit rate, but it isn't enough,'' said Robertson, who was not involved with the study.
The research, led by scientists at Erasmus University in Rotterdam, the Netherlands, involved 5,551 people in 15 European countries who suffered a heart attack or who underwent either open heart surgery to bypass clogged arteries or balloon angioplasty, where a tube is threaded through the blood vessels to a blockage and a balloon is inflated to squash the plaque against the walls of the artery.
About a year and a half later, they were interviewed about their smoking and given a carbon monoxide breath test to verify their answers.
About 40 percent of the patients were smoking before they had their heart scare. About 52 percent of those people continued to smoke after they had recovered.
When a similar study was conducted in 1996, 40 percent of smokers continued the habit after their heart trouble. However, the difference between these two studies was not statistically meaningful, so experts conclude there has probably not been much change in the proportion of people quitting smoking after the illness.
The smoking continued despite the fact that 88 percent of smokers in the study were advised to stop.
``Preventive cardiology regarding smoking cessation has not been improved since 1996,'' the study concluded. ``A considerable and increasing proportion of patients with coronary heart disease continues smoking, despite advice from their physicians to quit,'' the study said, adding that there is a need for better smoking cessation programs.
Studies have shown that nicotine replacement therapy, drugs that help curb the craving, and government policies such as smoking bans in public places, high taxes on tobacco and restrictions on cigarette advertising can substantially improve the chances of people kicking the habit.
The World Health Organization last year signed a global treaty aimed at curbing smoking and the millions of deaths it causes around the world. The treaty includes a ban on tobacco advertising and other restrictions, but countries are only now starting to implement it.
About 30 percent of European adults smoke. Rates are particularly high in Eastern Europe and rising sharply in the developing world. In the United States, about 23 percent of adults are smokers.