You are probably well aware that smoking causes lung cancer. However, did you know that far more smokers develop heart disease? Just over 400,000 people die each year due to smoking, and more than a third of those deaths are from heart disease and vascular disease. According to the American Heart Association, smokers are two to four times more likely to develop heart disease or have a stroke.
Quitting smoking improves your health in many ways. No matter how old you are or how long you have been smoking, breaking the habit benefits your heart. Let’s take a look at the ways that smoking harms your heart and how quitting helps.
How harmful is smoking?
Cigarette smoke contains more than 7,000 chemicals. The American Heart Association estimates that at least 250 of the chemicals in that toxic mix can hurt your health in a variety of ways. For example, they lead to lung diseases like chronic obstructive pulmonary disease (COPD) and lung cancer. These toxins also harm reproductive health, making it harder to conceive, and they put your unborn baby’s health at risk.
Scientists have identified several chemicals in cigarette smoke as particularly harmful to your heart. These include:
- Arsenic;
- Lead;
- Benzene;
- Hydrogen cyanide;
- Carbon monoxide.
How smoking affects heart health
The chemicals in cigarette smoke increase your risk of developing atherosclerosis, which is the buildup of plaque on the walls of your arteries, including those that supply oxygen-rich blood to your heart. This plaque, made up of cholesterol and other substances, narrows and stiffens arteries. Atherosclerosis leads to coronary artery disease (CAD), the most common form of heart disease.
If the buildup of plaque completely blocks an artery, that can cut off blood flow to your heart, causing a heart attack. Plaque also can rupture or burst, triggering the formation of blood clots that block your arteries and cause heart attacks.
Cigarette smoke also thickens your blood and damages your blood vessels. This makes it harder for blood to flow through your blood vessels and increases the risk of blood clots, which can cause a heart attack or stroke.
Smoking increases your risk of irregular heartbeat, or arrhythmia. For example, a 2018 review of the medical literature on the subject showed that your risk of atrial fibrillation (AFib), which causes abnormal electrical impulses sent to the heart, rises by 14% for every 10 cigarettes you smoke. AFib causes your heart to beat erratically and much too fast. As a result, your heart can’t pump blood efficiently. Blood can pool in your heart’s upper chambers, known as the atria. When that happens, blood clots may form. If one of these clots enters your bloodstream, it can block blood flow to your brain, causing a stroke.
Smoking also boosts your odds of developing heart failure. In a 2022 study, researchers found that cigarette smokers are two times more likely to suffer heart failure than people who have never smoked. Heart failure is a chronic condition that worsens over time as the heart loses its ability to pump blood efficiently. This condition damages your heart, kidneys, and liver, and can cause cardiac arrest which is fatal if not treated immediately.
Whenever you smoke, your blood pressure rises, and it takes about 20 minutes to return to normal. While experts don’t yet fully understand the relationship between smoking and high blood pressure, smokers are more likely to have high blood pressure than non-smokers. Also, recent research suggests that medications that lower blood pressure may be less effective in smokers. High blood pressure, which presents no symptoms, puts you at risk for:
- Heart attack;
- Heart failure;
- Coronary artery disease;
- Stroke.
How does quitting smoking improve heart health?
The above are all very good reasons to never start smoking. However, if you are already hooked, your heart will thank you for breaking that habit. When you quit smoking, your risk of developing or dying from heart disease drops considerably, according to the CDC. It does this in many ways. Some of the benefits occur right away, while others take time — in some cases, years. That’s why it’s important to quit as soon as possible.
When you quit smoking, the progression of atherosclerosis — the buildup of plaque on artery walls — slows down. The result: you reduce your risk of coronary artery disease. However, if you have already been diagnosed with CAD, you will still benefit from quitting. Experts say that quitting the habit cuts your risks of heart attack or dying from heart disease in half. Recent research suggests that smokers with heart disease may live five years longer if they quit smoking — the equivalent of taking three different heart disease medications.
Additionally, your risk of a heart attack drops dramatically within one to two years of quitting, and it continues to drop slowly over time. After 15 years, your risk of coronary artery disease should be about the same as that of a non-smoker.
Also, your HDL, or good, cholesterol level improves dramatically. HDL cholesterol helps rid your body of LDL, or bad, cholesterol. It does this by clearing LDL from the bloodstream and delivering it to the liver, where it gets broken down and eliminated from the body. A healthy level of HDL can reduce your chances of heart disease and stroke. According to the U.S. Food and Drug Administration, your risk of a stroke is about the same as that of a non-smoker four years after quitting.
If you still need more encouragement, the carbon monoxide level in your blood returns to normal in as little as 12 hours after you quit. This enables more oxygen to reach your heart.
What’s the best way to quit smoking?
Quitting is hard, but you can do it. There are plenty of health professionals willing to help — if you ask for it. Your doctor can explain the benefits of nicotine patches and other aids that will lessen your cravings and help wean you from your dependence on nicotine. Counseling groups and programs can increase your odds of success. Quitlines are another resource. These telephone-based programs help you develop your quit plan and stick to it. Call 1-800-QUIT-NOW to find a quitline in your area.
The American Heart Association offers these tips for those who want to quit:
- Set a quit date within the next week.
- Pick how you want to quit cold turkey or more gradually.
- Consider whether you’ll need help from your doctor and quit aids like nicotine patches.
- Make a plan to address nicotine cravings.
- Quit on your quit day.
- American Heart Association. Life's Essential 8™ - How to Quit Tobacco Fact Sheet.
- American Heart Association Go Red. Smoking and Heart Disease in Women.
- CDC. Benefits of Quitting.
- CDC. SMOKING AND CARDIOVASCULAR DISEASE.
- Cleveland Clinic. Heart Failure (Congestive Heart Failure).
Show all references
- European Journal of Preventive Cardiology. Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies.
- ESC. Smokers with heart disease could gain five healthy years by quitting.
- Johns Hopkins. Long-Term Study Finds Cigarette Smoking Doubled Risk of Developing Heart Failure.
- Johns Hopkins Medicine. Smoking and Cardiovascular Disease.
- Mayo Clinic. High blood pressure (hypertension).
- NIH. How Smoking Affects the Heart and Blood Vessels.
- Texas Heart Institute. Smoking and Your Heart.
- FDA. Harmful and Potentially Harmful Constituents in Tobacco Products and Tobacco Smoke: Established List.
- FDA. How Smoking Affects Heart Health.
- UCSF HEALTH. Smoking and Heart Disease.
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