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Smoking & Your Health

Most people associate cigarette smoking and tobacco use with breathing problems and lung cancer. But smoking is also a major cause of cardiovascular (heart and blood vessel) disease.

Smoking: the No. 1 cause of preventable disease and death

Smoking and tobacco use are significant risk factors for a variety of chronic disorders. According to the American Heart Association, cigarette smoking is the most important preventable cause of premature death in the United States, accounting for 440,000 of the more than 2.4 million annual deaths.

What's the link between smoking and cardiovascular disease?

Smoking is a major cause of atherosclerosis - a buildup of fatty substances in the arteries. Atherosclerosis occurs when the normal lining of the arteries deteriorates, the walls of the arteries thicken, and deposits of fat and plaque block the flow of blood through the arteries

In coronary artery disease, the arteries that supply blood to the heart become severely narrowed, decreasing the supply of oxygen-rich blood to the heart, especially during times of increased activity. Extra strain on the heart may result in chest pain (angina pectoris) and other symptoms. Coronary artery disease can lead to a heart attack.

In peripheral artery disease, atherosclerosis affects the arteries that carry blood to the arms and legs. As a result, the patient may experience painful cramping of the leg muscles when walking (a condition called intermittent claudication). Peripheral artery disease also increases the risk of stroke.

What's the link between smoking and heart attack?

A person's risk of heart attack greatly increases with the number of cigarettes he or she smokes. There is no safe amount of smoking. Smokers continue to increase their risk of heart attack the longer they smoke. People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than nonsmokers.

What's the link between smoking and oral contraceptives?

Women who smoke and also use oral contraceptives (birth control pills) increase several times their risk of coronary and peripheral artery diseases, heart attack, and stroke compared with nonsmoking women who use oral contraceptives.

What other medical conditions are linked with smoking?

Cigarettes have multiple poisons, including addictive nicotine, carbon monoxide, "tars," and hydrogen cyanide. There are 4,000 other chemicals of varying toxicity, including 43 known carcinogens.

Smoking causes:

  • Decreased oxygen to the heart and to other tissues in the body
  • Decreased exercise tolerance
  • Decreased HDL (good) cholesterol
  • Increased blood pressure and heart rate
  • Increased risk of developing coronary artery disease and heart attack
  • Increased risk of developing peripheral artery disease and stroke
  • Increased risk of developing lung cancer, throat cancer, chronic asthma, chronic bronchitis, and emphysema
  • Increased risk of developing diabetes
  • Increased risk of developing a variety of other conditions, including gum disease and ulcers
  • Increase tendency for blood clotting
  • Increased risk of recurrent coronary artery disease after bypass surgery
  • Damage to cells that line coronary arteries and other blood vessels
  • Increased risk of becoming sick (especially among children: respiratory infections are more common among children exposed to secondhand smoke)

How does smoking affect others?

Cigarette smoke doesn't just affect smokers. When you smoke, the people around you are at risk for developing health problems, especially children. Environmental tobacco smoke (also called passive smoke or secondhand smoke) affects people who are frequently around smokers. Secondhand smoke can cause chronic respiratory conditions, cancer, and heart disease. The American Heart Association estimates that each year, about 37,000 to 40,000 people die from heart and blood vessel disease caused by other people's smoke.

The benefits of quitting smoking

Now that you know how smoking can be harmful to your health and the health of those around you, find out how quitting smoking can be helpful.

By quitting smoking, you will:

  • Prolong your life. According to the American Heart Association, smokers who quit between the ages of 35 and 39 add an average of 6 to 9 years to their lives. Smokers who quit between the ages of 65 and 69 increase their life expectancy by 1 to 4 years.
  • Reduce your risk of cardiovascular disease. Quitting smoking reduces the risk of repeat heart attacks and death from heart disease by 50 percent or more.
  • Reduce your risk of high blood pressure, peripheral artery disease, and stroke.
  • Reduce your risk for developing a variety of other conditions, including diabetes, lung cancer, throat cancer, emphysema, chronic bronchitis, chronic asthma, ulcers, gum disease, and many other conditions.
  • Feel healthier. After quitting, you won't cough as much or have as many sore throats, and you will increase your stamina.
  • Look and feel better. Quitting can help you prevent face wrinkles, get rid of stained teeth, improve your skin, and even get rid of the stale smell in your clothes and hair.
  • Improve your sense of taste and smell.
  • Save money

How can I quit?

There's no one way to quit that works for everyone. To quit smoking, you must be ready emotionally and mentally. You must also want to quit smoking for yourself, and not to please your friends or family. Plan ahead.

Before you quit:

(Check off these items as you accomplish them)

  • Make a personal pact with yourself to quit and realize the reasons why you want to quit!
  • Write down, on a card, the three most important reasons for quitting.
  • Carry that card with you (or in your cigarette box) from now on. Look at it several times each day.
  • Set a date for quitting completely! (My date is ___/___/___).
  • Make sure to let your friends and family know that you are quitting smoking, especially if they smoke.
  • Reduce consumption with the taper method given to you. If you are over a pack, try to get less than a pack.
  • Identify barriers or triggers that may cause you to smoke.
  • Prior to quitting, taper or eliminate smoking completely in two or three of your high risk situations.
  • Understand that withdrawals symptoms may come, what they are, and be prepared for their occurrence.
  • Spend a little time each day picturing in your mind stressful events occurring in the future and you not smoking.
  • Get rid ofALL cigarettes and put away all smoking related objects such ashtrays. Ask people you live with not to smoke in your presence for two weeks.
  • Consider the following for extra support: A person to quit with you; Joining a web-based program; Reading a book on quitting; Calling the Quit line (1-800-QUITNOW)
Optional but recommended:
  • Change to a less desirable brand of cigarettes.
  • Discard your lighter, use matches.
  • Carry your cigarettes in a different place.
When you quit:
  • Again get rid of ALL cigarettes!
  • Put away all smoking related objects such ashtrays. Ask people you live with not to smoke in your presence for two weeks
  • Be prepared for the hump days after the quit day (Days 2-5)! Make them "That is okay" days
  • When cravings come - remind yourself of why you are quitting (from you card) and that they will last only a few seconds to minutes!
  • When urges and withdrawal symptoms come - remind yourself that whatever discomfort you are experiencing is only a tiny fraction of the probable discomfort associated with continued smoking (i.e., painful diseases, surgery, chemotherapy).
  • Spend as much time as possible with non-smoking people.
  • Keep busy, especially on evenings and weekends.
  • Avoid "high risk" situations (large parties, bars, etc.), and spend lots of time in places which prohibit or discourage smoking (e.g., theaters, libraries).
  • Use approved alternates (e.g., ice water, high bulk/low calorie foods, sugarless gum, mouthwash, & brushing teeth). Don’t substitute food or sugar based products for cigarettes.
  • Drink plenty of fluids (avoid excess caffeine in pop, coffee, or tea)
  • Begin (or increase) a regular exercise program
  • Practice deep breathing or other relaxation techniques. In the nose out the mouth slowly and several times.
  • Take your medication(s) as designated by your clinician.
  • Remind yourself that you can free yourself from this unhealthy, expensive, messy habit and become a nonsmoker.

How will I feel when I quit?

You may crave cigarettes, be irritable, feel very hungry, cough often, get headaches, have difficulty concentrating, or experience constipation. These symptoms of withdrawal occur because your body is used to nicotine, the active addicting agent within cigarettes.

When withdrawal symptoms occur within the first two weeks after quitting, stay in control. Think about your reasons for quitting. Remind yourself that these are signs that your body is healing and getting used to being without cigarettes.

The withdrawal symptoms are only temporary. They are strongest when you first quit but will go away within 10 to 14 days. Remember that withdrawal symptoms are easier to treat than the major diseases that smoking can cause.

You may still have the desire to smoke. There are many strong associations with smoking, such as smoking during specific situations, with a variety of emotions, or with certain people in their lives. The best way to overcome these associations is to experience them without smoking.

If you smoke again (called a relapse), do not lose hope. Seventy-five percent of those who quit relapse. Most smokers quit three times before they are successful. If you relapse, don't give up! Review the reasons why you wanted to become a nonsmoker. Plan ahead and think about what you will do next time you get the urge to smoke.

What happens when you quit?

After 20 minutes
You stop polluting the air
Your blood pressure and pulse decrease
The temperature of your hands and feet increases

After 8 hours
The carbon monoxide level in your blood returns to normal
Oxygen levels in your blood increase

After 24 hours
Your risk of heart attack decreases

After 48 hours
Nerve endings adjust to the absence of nicotine
Your ability to taste and smell begins to return

After 2 weeks to 3 months
Your circulation improves
Your exercise tolerance improves

After 1 to 9 months
Coughing, sinus congestion, fatigue, and shortness of breath decrease
Your overall energy level increases

After 1 year
Your risk of heart disease decreases to half that of a current smoker

After 5 to 15 years
Your risk of stroke is reduced to that of people who have never smoked

After 10 years
Your risk of dying from lung cancer drops to almost the same rate as a lifelong NON-smoker.
You decrease the incidence of other cancers – of the mouth, larynx, esophagus, bladder, kidney and pancreas

After 15 years
Your risk of heart disease is reduced to that of people who have never smoked

Resources: where to get help

You need to decide to give yourself the most precious gift a smoker can give to him or herself -- a gift of life, health and self-esteem -- by becoming a nonsmoker.

Cleveland Clinic Tobacco Treatment Center is based on the latest scientific knowledge. We can help you understand all the treatment options available and create a customized plan to help you quit successfully.

How does it work?

  1. You’ll start by meeting with a certified tobacco cessation specialist. You’ll learn how much you depend on nicotine, how ready you are to quit, and what your preferred method of learning is.
  2. Your specialist will develop a personalized treatment plan for you. This may include tobacco treatment medication such as varenicline (Chantix®), bupropion (Zyban®) and nicotine replacement therapy (NRT) such as nicotine gum or the patch. Behavioral therapy such as appropriate reading material, web-based programs, and individual or group counseling will also be available.
  3. The tobacco treatment specialist will stay in touch with you to check on your progress, find out how well treatment is working for you - and celebrate your successes.

Program cost

Treatment costs may vary based on the personalized treatment plan developed for each participant and their ability to pay.

Please call 216.444.8111. Appointments can be made at Main Campus, Beachwood, Chagrin Falls, Independence, Fairview, Solon, Strongsville, Westlake, Willoughby, and Wooster Family Health Centers.

Ohio Quitline: 1.800.TRY.TO.STOP (1.800.934.4840)

You may also contact your local chapter of the American Cancer Society, American Heart Association, or the American Lung Association.

There are numerous government resources online to help you quit smoking, including the Centers for Disease Control, National Cancer Institute, National Clearinghouse for Alcohol and Drug Information, World Health Organization Tobacco-Free Initiative, and many more.

© Copyright 1995-2010 The Cleveland Clinic Foundation. All rights reserved.

Can't find the health information you’re looking for?

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/15/2010...#4585