Smoking And Your Heart

Mixed-race young woman smoking a cigarette
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Smoking tobacco is the strongest controllable risk factor for developing heart disease. While almost every smoker understands that smoking increases the risk of cancer, many (unfortunately) are unaware that they are also greatly increasing their risk of cardiovascular disease at an early age.

Smoking and the Risk of Heart Disease

In fact, the risk of having a heart attack is six times higher in women smokers, and three times higher in men smokers, than in people who never smoked.

(While smoking is bad for everyone, it is now well established that it is particularly dangerous for women.) 

World-wide, smoking is thought to account for almost 36% of first heart attacks.

Not only does smoking cause heart disease, but once you develop heart disease, continuing to smoke makes it much worse, much faster.

People who keep smoking after a heart attack have a much higher risk of subsequent heart attacks. People who smoke after bypass surgery or stenting have a much higher incidence of developing occlusion of the bypassed or stented artery. Smokers with coronary artery disease (CAD) or heart failure have a substantially higher risk of premature death than non-smokers with these conditions.

Smoking tobacco greatly accelerates atherosclerosis, a disease process that produces CAD, heart failureperipheral vascular diseasestrokeabdominal aortic aneurysms, and sudden death.

How Does Smoking Cause Heart Disease?

Smoking accelerates atherosclerosis in several ways:

  • Smoking increases LDL cholesterol (bad cholesterol) levels, and reduces HDL cholesterol (good cholesterol).
  • Tobacco products contain chemicals that can irritate the blood vessel walls, increasing inflammation, damaging and "stiffening" the vessel walls — all conditions that are associated with atherosclerosis.
  • Smoking increases adrenaline levels, which raises the blood pressure and cardiac stress, causing constriction of blood vessels.
  • Smoking abnormally increases the tendency of blood to form clots within blood vessels, thus increasing the risk of acute coronary syndrome (ACS).

In addition to accelerating atherosclerosis, smoking tobacco has other deleterious effects on the cardiovascular system:

  • The nicotine in tobacco contributes to the increase in heart rate and blood pressure seen after smoking a cigarette.
  • Smoking increases serum homocysteine levels, which is thought to cause vascular injury.
  • Smoking increases carbon monoxide levels, reducing the blood’s capacity to deliver oxygen to the tissues.

Furthermore, smoking does not only affect the person who has decided to be a smoker; it affects family, friends, and loved ones who breathe secondhand smoke. While the data establishing that secondhand smoke increases the risk of cardiovascular disease is not as firmly established as it is for smokers themselves, most studies agree that it does increase the risk for innocent bystanders. 

The Acute Effects Of Smoking A Cigarette

Several of the deleterious effects that are produced by smoking are relatively acute.

Changes in the heart rate and blood pressure, the negative clotting effects, and even some of the chemical changes within the blood vessels can occur immediately when you light up.

The Cardiac Benefits Of Smoking Cessation

Just as smoking tobacco accelerates atherosclerosis, if you quit smoking you can slow the progression of atherosclerosis. Furthermore, smoking cessation actually substantially improves the overall function of your blood vessels. The risk of developing cardiovascular disease drops quickly after you quit smoking, and continues dropping the longer you remain tobacco-free.

After an episode of ACS, smokers who quit immediately have a much lower risk of dying in the near future, as compared to smokers who do not quit.

Quitting also substantially reduces your risk of having a further episode of ACS.

Your risk of stroke also becomes substantially reduced over time after you quit smoking.

The benefits of smoking cessation are seen in both men and women in all age groups.

Why You Should Quit Right Now

Many of the adverse affects of smoking occur acutely — right after you light up. This means that your chances of having an acute heart attack will actually diminish within 24 - 48 hours after your last smoke.

So not only should you quit smoking, you should quit smoking as soon as you possibly can.

A Word From Verywell

Smoking is the leading preventable cause of premature heart disease and stroke. The benefits of smoking cessation are strongly established, and those benefits begin to take place within a day or two of your last cigarette. 

Sources:

Mozaffarian D, Benjamin EJ, Go AS, et al. Heart Disease and Stroke Statistics--2015 Update: a Report from the American Heart Association. Circulation 2015; 131:e29.

Raghuveer G, White DA, Hayman LL, et al. Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e336.

Huxley RR, Woodward M. Cigarette Smoking as a Risk Factor for Coronary Heart Disease in Women Compared With Men: a Systematic Review and Meta-analysis of Prospective Cohort Studies. Lancet 2011; 378:1297.

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