In addition to an overall roughly double cardiovascular risk, smoking significantly increases the incidence of thromboembolic disease and pulmonary embolism, especially in interaction with hormonal contraception. However, tobacco dependence is a chronic recurrent disease that is not easy to get rid of.
The case report describes several years of unsuccessful treatment of tobacco dependence of a girl from a smoking family who has been our patient from her age of 14 to 19. She had a total of 5 attempts to stop smoking, but she succeeded to be abstinent for 3 months at most.
After six months of hormonal contraception use, she suffered a pulmonary embolism, yet she did not stop smoking.