Tobacco and CVD

Smoking and CVD

  • If smoking did not exist, then there were would 1.62 million fewer cardiovascular deaths (CVD) every year.1
  • Using tobacco causes stiffening and clogging of the arteries, leading to heart disease, stroke, sudden death, and heart failure.2
  • Smoking is a powerful cardiovascular risk factor. CVD risk increases in linear fashion with the number of cigarettes smoked each day leading to a twofold risk of death among smokers compared to non-smokers.2, 3 The risk of CVD persists even at one to two cigarettes smoked a day.4
  • Smoking 15 cigarettes a day can increase the risk for stroke by up to four times.5
  • Smoking leads to high blood pressure and causes complications in established high blood pressure.6
  • Young smokers are particularly at risk of CVD, especially young men.7

Smoking and CAD

  • A quarter of tobacco-related deaths are accounted for by coronary artery disease      (CAD).2
  • Smoking more than 25 cigarettes a day increase a person’s risk of heart attack 8 times compared to people who never smoke. 7
  • Women smokers who use oral contraceptives have a high risk of heart disease, so much so that doctors have been advised not to prescribe the pill to smokers over 34 years old and especially not to smokers over 39 years old. 8
  •  Chewing tobacco more than doubles the risk of heart attack.7
  • A patient who continues to smoke after a heart attack or coronary bypass graft has double the risk of death and reinfarction.
  • Smoking could reduce the beneficial effect of physical activity for reduction of  CAD and current smokers are less likely to engage in exercise of sufficient intensity than non-smokers.9
  • A review of data from more than 2.4 million people and more than 44,000 CAD events suggests that, compared with nonsmokers, women who smoke may have a 25% greater relative risk of CAD than do male smokers, independent of other cardiovascular risk factors.10 

Tobacco Abstinence and Smoking Cessation: 

  • Smoking cessation is probably the single most effective lifestyle measure for the prevention of CVD. This is supported by the observation that those who quit smoking before middle age typically have a life expectancy that is not different from that of lifelong non-smokers.
  • Within two years of quitting, the risk of CAD is substantially reduced.15 years after quitting the risk of CVD returns to that of a non-smoker.2
  • The earlier one stops the better: stopping smoking at age 50 halves the risk of a tobacco-related death, and cessation at age 30 avoids almost all of it.2 Smokers who quit at age 35 live up to 9 years longer for men and up to 8 years longer for women than people who continue to smoke.11
  • Quitting when older is still worthwhile: among smokers who quit at age 65 years, men gained up to 2.0 years of life, and women gained up to 4 years.11


1. Ezzati M, Henley SJ, Thun MJ, Lopez AD. Role of smoking in global and regional cardiovascular mortality. Circulation. Jul 26 2005;112(4):489-497.

2. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Bmj. Jun 26 2004;328(7455):1519.

3. JR E, Whincup PH, Morris RW, Wannamethee SG, Shaper AG. Lifestyle and cardiovascular disease in middle-aged British men: the effect of adjusting for within-person variation. Eur Heart J. Sep 2005;26(17):1774-1782.

4. Vollset SE, Tverdal A, Gjessing HK. Smoking and deaths between 40 and 70 years of age in women and men. Ann Intern Med. Mar 21 2006;144(6):381-389.

5. Kurth T, Kase CS, Berger K, Gaziano JM, Cook NR, Buring JE. Smoking and risk of hemorrhagic stroke in women. Stroke. Dec 2003;34(12):2792-2795.

6. McAlister FA, Lewanczuk RZ, Teo KK. Resistant hypertension: an overview. Can J Cardiol. Sep 1996;12(9):822-828.

7. Teo KK, Ounpuu S, Hawken S, et al. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. Aug 19 2006;368(9536):647-658.

8. Keeling D. Combined oral contraceptives and the risk of myocardial infarction. Ann Med. 2003;35(6):413-418.

9. Noda H, Iso H, Toyoshima H, et al. Smoking status, sports participation and mortality from coronary heart disease. Heart. Oct 4 2007.

10. 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. Aug 10 2011.

11. Taylor DHJr, Hasselblad V, Henley SJ, Thun MJ, Sloan FA. Benefits of smoking cessation for longevity. Am J Public Health. Jun 2002;92(6):990-996.

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