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Heart Health and Smoking


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Cigarette smoking is the chief cause of preventable disease and death in the United States and can harm nearly any part of the body. Cigarette smoke is a toxic mix of more than 7,000 chemicals1 and, when inhaled, can interfere with important processes in the body that keep it functioning normally. One of these processes is the delivery of oxygen-rich blood to your heart and the rest of your body.

How Does Smoking Affect Your Cardiovascular Health?

When you breathe in air from the atmosphere, the lungs take in oxygen and deliver it to the heart, which pumps this oxygen-rich blood to the rest of the body through the blood vessels. But when you breathe in cigarette smoke, the blood that is distributed to the rest of the body becomes contaminated with the smoke’s chemicals. These chemicals can damage to your heart and blood vessels,1 which can lead to cardiovascular disease (CVD)—the leading cause of all deaths in the United States.2

CVD is a generic term referring to multiple conditions affecting the heart or blood vessels3. Some of these conditions include:

  • coronary heart disease
  • hypertension (high blood pressure)
  • heart attack
  • stroke
  • aneurysms
  • peripheral artery disease1,2

In addition to permanently damaging your heart and blood vessels, cigarette smoke can also cause CVD by changing your blood chemistry1,2 and causing plaque—a waxy substance comprised of cholesterol, scar tissue, calcium, fat, and other material3—to build up in the arteries, the major blood vessels that carry blood from your heart to your body. This plaque buildup can lead to a disease called atherosclerosis.

When the chemicals in cigarette smoke cause atherosclerosis and thickened blood in the arteries, it becomes more difficult for blood cells to move through arteries and other blood vessels to get to vital organs like the heart and brain.4 This can create blood clots and ultimately lead to a heart attack or stroke, even death.1,2

Other rare but serious cardiovascular conditions that can be caused by smoking include:

  • Peripheral Artery Disease (and peripheral vascular disease): A condition in which the narrowing of blood vessels results in insufficient blood flow to arms, legs, hands, and feet. Smoking is the leading preventable cause of this condition, which can result in amputation.
  • Abdominal aortic aneurysm: A bulge that is formed in an area of the aorta—the main artery that distributes blood through the body—that sits in the abdomen. When an abdominal aortic aneurysm bursts, it can result in sudden death. More women than men die from aortic aneurysms, and nearly all deaths from this condition are caused by smoking.4

Impact of Cardiovascular Disease Caused by Smoking

According to the American Heart Association, CVD accounts for about 800,000 U.S. deaths every year,5 making it the leading cause of all deaths in the United States. Of those, nearly 20 percent are due to cigarette smoking.2

While smoking is a direct cause of cardiovascular disease and death, you don’t have to be a smoker to be at risk. Nonsmokers who are regularly exposed to secondhand smoke have a 25 to 30 percent increased risk of coronary heart disease than those not exposed.6 In fact, 30,000 U.S. coronary heart disease deaths per year are caused by secondhand smoke.7 Secondhand smoke exposure also increases your risk of having a heart attack or stroke.6,7


How Can You Protect Your Heart?

Woman looking at her watch

The best way to safeguard your heart from smoking-related disease and death is to never start using cigarettes, but if you are a smoker, the earlier you are able to quit, the better. Quitting smoking benefits your heart and

cardiovascular system now and in the future:

  • Twenty minutes after you quit smoking, your heart rate drops.8
  • Just 12 hours after quitting smoking, the carbon monoxide level in the blood drops to normal, allowing more oxygen to vital organs like your heart.8
  • Within four years of quitting, your risk of stroke drops to that of lifetime nonsmokers.9

Although quitting smoking is difficult, it is achievable, and medicinal cessation therapies like nicotine replacement therapy (NRT) may be able to help you on your quit journey. Many addicted smokers find that FDA-approved NRT helps them get through the hardest parts of quitting by lessening cravings and symptoms of withdrawal. NRTs are proven safe and effective to help you quit smoking by delivering measured amounts of nicotine without the toxic chemicals found in cigarette smoke.

If you are a smoker and you are concerned about your cardiovascular health, consulting with your doctor about NRTs or other cessation options and seeking help with quitting may help you protect your heart long-term.


FDA Plans to Make Cigarettes Less Addictive

person breaking a cigarette in half

In 2017, FDA Commissioner Scott Gottlieb, M.D., announced the agency’s intention to lower nicotine levels in cigarettes to minimally addictive or nonaddictive levels. While this action would not remove cigarettes from the market, reducing their addictiveness would help addicted adult smokers quit altogether or switch to potentially less harmful tobacco products.


Additional Resources


1. U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.
2. U.S. Department of Health and Human Services (USDHHS). Let’s Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General’s Report on Smoking and Health (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
3. National Heart, Lung, and Blood Institute. Know the Differences: Cardiovascular Disease, Heart Disease, Coronary Heart Disease. https://www.nhlbi.nih.gov/sites/default/files/media/docs/Fact_Sheet_Know_Diff_Design.508_pdf.pdf. Accessed January 253, 2019.
4. Centers for Disease Control and Prevention Office on Smoking and Health. Smoking and Cardiovascular Disease Fact Sheet. Surgeon General’s Report on Smoking and Health 50th Anniversary. https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_CVD_508.pdf. Accessed January 23, 2019.
5. Benjamin EJ, Virani SS, Callaway CW, et al. Heart disease and stroke statistics--2018 update: a report from the American Heart Association. Circulation. 2018; 137(12).
6. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.
7. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
8. U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
9. U.S. Department of Health and Human Services (USDHHS). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.



Audience: Health Professional, Public Health Community

Topics: Science/Research, cigarettes, health education, health effects, prevention

Source: https://www.fda.gov/tobacco-products/health-information/how-smoking-affects-heart-health